Continuous Therapy Is Better

It is well known that much research in the area of the treatment of HIV and AIDS is constantly being conducted. One study on the comparison of episodic to continuous antiretroviral therapy which was being conducted has been halted due to the increased risk of disease progression in the episodic treatment group.

There is a tendency within third world countries to have patients who are HIV positive to begin treatment but then to stop as soon as the symptoms begin to subside and then to begin again once the virus begins to recover and symptoms re-emerge. This is clinically known as episodic therapy. Continuous therapy would involve the treatment continuing without interruption regardless of the severity of the symptoms. For more information on hiv insurance, go to

The trial which was conducted and stopped was known as Strategies for Management of Anti-Retroviral Therapy or SMART. The study was designed to compare and contrast the results of both the aforementioned treatment strategies, namely episodic and continuous therapy. The study involved assigning HIV positive volunteers to one of two groups, one group which focussed on virus suppression or continual therapy whilst the other group focussed on drug conservation or episodic treatment. This second group only began receiving treatment when the CD4+ T cell count dropped below 250 cells per cubic millimetre and ceased when the CD4+ T cell count rose to above 350 cells per cubic millimetre.

The study found that the episodic treatment group faced twice the risk of disease progression as well as increased incidence of complications such as liver disease, kidney disease and cardiovascular problems. These statistically significant health complications and life endangerment factors led to the cessation of the study not long after it was started. It was decided that the risk to the episodic treatment group was too high. Therapy was restarted for all patients in the drug conservation group and follow-up consultations will continue for all the participants in the trial.

The conclusions that were drawn from the study indicated that episodic anti-retroviral therapy carries a much higher risk and does not show any evidence of decreasing the risk of experiencing the side effects of the anti-retroviral treatment. This information is crucial for all physicians treating HIV positive individuals and should lead to an improvement in the management of the treatment of the disease in general as more individuals are made aware of the risks involved in electing to participate in therapy in an episodic manner rather than in a continuous manner.

Those conducting the study were surprised to come to the conclusions that they cam e to as quickly as they did. The trial was scheduled to run for a far longer period of time than it did. Further studies are planned to establish the long term effects of episodic therapy as well as continuous therapy in the hopes of establishing a best practice for the treatment of HIV with anti-retroviral medication. It is also hoped that the results of this study will assist physicians in convincing patients to continue with treatment for longer periods of time.


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