Could we safely reduce the frequency of treatments for HIV-positive people?
Résumé
Most HIV-positive people under treatment take a daily dose of antiviral drugs for life. However, a major trial is currently underway in France that may confirm that patients could safely omit several days of treatment a week without risk to their health. Some 300 patients have already switched to a treatment mode called “Intermittent in short cycles”, taking their medication four days a week instead of the seven currently specified. The small protocol began several years ago and the patients are doing well.
A larger trial is currently underway, and if the initial findings are confirmed, it could have significant benefits around the globe. At the end of 2016, 37 million people were living with HIV, with 1.6 million new infections that year alone. The vast majority of those living with HIV are in lower-income countries, particularly in Sub-Saharan Africa. Globally, only 21 million of those infected have access to antiretroviral therapy. If only four days of treatment are necessary for many patients, however, the same supply of antiretroviral drugs would go much further – and in particular, out into the developing world.
In September 2017, the French Agency for Research on HIV/AIDS, ANRS, launched a large clinical trial called Quatuor (Quartet in English) of the four-day-a week protocol. It involves 640 volunteers recruited from 63 public hospitals in France and the Caribbean. Dr. Pierre de Truchis, at Raymond Poincaré Hospital in Garches (Hauts-de-Seine), is the principal investigator.
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