HEALTH: New Treatment for AIDS

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Aug 1 2000 (IPS) - One of the most intriguing innovations presented this month at the International AIDS Conference consisted of a method that reduces the levels of human- immunodeficiency virus (HIV) through successive interruptions of the treatment with medication.

The researchers who presented the new developments at the Jul 9- 14 conference in Durban, South Africa said “Structured Treatment Interruption” (STI) was still in the experimental stage. But, they added, it could modify the paradigm governing the treatment of an epidemic that has claimed 18.8 million lives worldwide in less than 20 years.

Until recently, scientists believed it essential that the patient being treated with the triple combination therapy against the acquired immunodeficiency syndrome (AIDS) never interrupt treatment, because any gap in the therapy could generate resistance to the anti-retroviral drugs.

Experience demonstrated that in patients receiving the cocktail drug treatment, the levels of HIV in the blood dropped, and when the medicine was cut off, the HIV count rose once again.

Treatment with anti-retroviral drugs is aimed at containing the spread of HIV, which is never completely eliminated.

The new research presented in Durban found that when treatment was cut off, HIV counts did increase, but not to levels as high as those found prior to the start of treatment.

With STI, patients would receive the triple combination therapy for a period of weeks or months, and then stop taking the drugs temporarily. Their virus counts would rise, but to increasingly lower levels.

STI was introduced at the Durban congress by David Ho from New York. Another team is carrying out similar tests in the Cantonal Hospital of Geneva.

The new treatment option may enable the presence of HIV to be controlled, even with a limited amount of anti-retroviral drugs, said Jose Esparza, the coordinator of the HIV Vaccine Initiative, a joint programme of the World Health Organisation (WHO) and the United Nations Programme on HIV/AIDS (UNAIDS).

The innovation would modify the treatment model predominant until recently, aimed at totally eradicating the virus, so that no cell showed any trace of HIV.

But the growing conviction is that total elimination of HIV is impossible, and probably unnecessary, said Esparza.

STI offers apparent advantages over continuous treatment. The patient takes only half the amount of drugs currently administered, thus reducing the levels of toxicity in their body. Taking a break from the triple combination therapy for a few weeks or months would help the patient regain strength and fight side- effects.

But one of the key elements of the innovation is the reduction of the cost of the cocktail drug treatment, which currently carries a pricetag of around 10,000 dollars a year per patient, according to UNAIDS.

The high cost, which makes treatment inaccessible to the lion’s share of AIDS patients in developing countries — which account for 90 percent of the 34.3 million people living with HIV/AIDS worldwide — constitutes the biggest social and health problem facing UNAIDS and the WHO today.

But scientists have reacted cautiously to STI, warning their patients against suspet spreads are known: sexual transmission, from mother to child, through the sharing of syringes by drug users or through infusions of infected blood. But scientists point out that they lack the instruments to control, prevent or eradicate the disealast.

In some aspects, AIDS is similar to diabetes, which is also an incurable, chronic disease that can be controlled within limits, Esparza pointed out.

In theory, the AIDS epidemic can be controlled, because the routes through which it spreads are known: sexual transmission, from mother to child, through the sharing of syringes by drug users or through infusions of infected blood. But scientists point out that they lack the instruments to control, prevent or ts point out that they lack the instruments to control, pr