Structured treatment interruptions: after SMART.

Abstract

The recent termination of several major studies of structured treatment interruption (STI)--the term for taking a planned break from anti-HIV medications--has drawn heightened attention to this treatment strategy. Always a controversial and intriguing approach, STI has been the focus of large-scale trials only in the last several years. Since January, three such studies have been halted early after researchers found that individuals who stop and start highly active antiretroviral therapy (HAART) are at greater risk of HIV disease progression and serious illness than those who take treatment continuously. However, other studies show that many questions remain about the risks involved. There is still considerable interest in both the research and HIV positive communities in better understanding the effects of interrupting anti-HIV therapy. This article provides an overview of STI, including some of the recent research findings, and examines several issues that people contemplating a break from treatment should consider.