Abstract
In 1999, researchers reported the ‘Berlin patient’, the first instance of successfully controlling HIV viremia after interruption of antiretroviral treatment (ART) [1]. This case report raised the possibility that intermittent ART might have a place in the management of HIV infection. Since then, structured treatment interruptions (STIs) as an experimental alternative strategy in the management of HIV infection have been investigated in a variety of settings [2]. STI is defined as an experimental strategy investigating effects of predetermined interruptions of ART for a variable or fixed duration in selected HIV-infected participants, guided by CD4 or HIV-RNA levels in controlled clinical trial settings. Fixed-cycle STIs refer to interruptions in therapy that are of a set duration (i.e., 1–3 months) cycled with reintroduction of therapy of similar duration’ [3]. CD4-guided STIs are strategies in which interruptions in ART are attempted at CD4 levels above 350 cells/ml with reintroduction of ART at variable levels of CD4 cell count (250–350 cells/ml). STIs in controlled trial settings have been attempted in three categories of HIV-infected patients:
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