The Pharmaceutical Journal
Vol 276 No 7385 p98
28 January 2006

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Episodic antiretroviral treatment harms patients

Enrolment of subjects in a large international HIV/AIDS trial to compare episodic with continuous antiretroviral treatment has ceased. The decision follows an analysis of interim study data, which showed that subjects on episodic treatment had more than twice the risk of disease progression compared with those taking continuous antiretroviral therapy.

The US trial, known as SMART (strategies for management of antiretroviral therapy), was designed to investigate whether patients could be spared some of the toxic effects of long-term antiretroviral therapy by using a CD4 cell-guided episodic “drug conservation” strategy. However, in addition to the increased risk of clinical AIDS or death, investigators also saw an increase in major antiretroviral toxicities such as cardiovascular, kidney and liver complications.