Study Shows Treatment-Weary HIV+ Undetectables Could Skip Pills

A new study presented at the International Congress on Drug Therapy in HIV Infection shows that HIV-positive people with undetectable viral loads maintained viral suppression even after missing a few days of treatment.

In an article in HIV Plus, David Artavia writes that a French pilot study has shown that treatment-weary pozzers could exchange their daily dose of HIV meds with a four-day on, three-day off routine, without compromising viral suppression. It could also yield significant savings on HIV meds.

Some feared that a break in treatment could lead to rising viral loads and drug resistance. But the study revealed that these fears are unfounded. It followed 100 people living with undetectable HIV loads for at least four years. They were instructed to take a three-drug regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) and either a boosted protease inhibitor or an NNRTI on this staggered schedule.

After 48 weeks of this routine, 96 out of 100 participants had maintained viral suppression below 50 copies/ml. Three of them experienced a rebound, and another quit the regiment altogether after just four weeks. Drug levels declined to extremely low detectable levels, but overall viral suppression was maintained.

This four-day on/three-day off plan cuts down the cost of meds by a large fraction without any significant problems. The three participants who had viralogic rebounds were taking abacavir-based treatments in combo with a boosted protease inhibitor. These rebounds were noticeable at four, 12, and 40 weeks after the new routine.

A larger follow-up study is being planned, which will involve 640 people undergoing the four-day on/three-day off routine for two years. Researchers are interested in seeing the long-term effects of such a regiment, while also seeing how it impacts one's quality of life, both financially and emotionally.

Researchers warn that you shouldn't try this at home, especially without consulting your doctor, but are cautiously optimistic about the findings.