Structured Treatment Interruptions: A Risky Business

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Abstract
HAART has dramatically altered the natural history of HIV disease [1–5]. However, currently available treatments are suppressive and cannot eradicate HIV infection [6–8]. As a result, antiretroviral therapy in 2004 represents a life-long proposition requiring exceptionally good—if not perfect—adherence [9]. Unfortunately, many issues, including the complexity of the regimens, drug toxicities, drug interactions, lifestyle issues, and comorbidities, may interfere with achievement of this goal [10–14]. In recent years, a variety of therapeutic strategies have been developed to alleviate some of these problems: several safer and better-tolerated agents have been approved, simpler regimens with once-daily dosing are now possible, and fixed-dose combinations of antiretroviral agents are also available. In addition, deferring initiation of antiretroviral therapy has been widely recommended [15–18].