Structured intermittent therapy
Encyclopedia
Structured intermittent therapy (SIT) was coined in early 2000 by Mark Dybul
Mark R. Dybul
Ambassador Mark R. Dybul served as the United States Global AIDS Coordinator, leading the implementation of the President's Emergency Plan for AIDS Relief during the presidency of George W. Bush.-Biography:...

, Anthony Fauci
Anthony Fauci
Anthony S. Fauci is an immunologist who has made substantial contributions to research in the areas of AIDS and other immunodeficiencies, both as a scientist and as the head of the National Institute of Allergy and Infectious Diseases .-Education and career:Anthony Stephen Fauci was born on...

, and other research scientists from the National Institute of Health, as a form of reduced treatment for patients with HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

. HIV+ patients took anti-HIV drugs for seven days, and then took no drugs for seven days.

Generally, patients with HIV who were being treated aggressively with continuous highly active antiretroviral therapy (HAART) lived longer lives, but they were not able to eliminate the HIV virus
Virus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...

altogether and experienced many undesirable side effects. The long-term toxicity and financial expense of HAART makes it undesirable as the standard, long-term treatment for HIV patients. Consequently, a short study on administering medications in a structured intermittent manner was designed. The hope of this 2001 study was that alternating weeks of drug-taking with weeks of drug abstinence would both reduce toxicity and cost to the patients.

This small, uncontrolled study found that a structured intermittent therapy (SIT) approach may help to maintain health while also reducing cost and toxicity of antiretroviral therapy. This approach might have had particular applicability in resource-poor settings where access to therapy is limited by the cost of antiretroviral agents.

Failure

The Strategies for the Management of Antiretroviral Therapy (SMART) trial was intended to provide good information on whether this approach worked for HIV+ people. The double-blind controlled study began in 2002 and enrolled 5,472 participants in 33 countries. Unfortunately for proponents of SIT, the study had to be stopped in 2006 because of the excessive number of "interrupted" patients who died or got much sicker.http://www.thebody.com/content/treat/art1759.html People on the SIT protocol were more than twice as likely to die during the study than people who took HAART drugs continuously.
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