Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

Reuters NewMedia, Wednesday October 21, 1998
Maggie Fox, Health and Science Correspondent

The multi-drug combination has been shown to suppress the virus to nearly undetectable levels, but once patients stop taking the drugs, the virus comes back.

Doctors hope there is a point at which the patient's immune system can recover and battle the virus on its own, but have not been willing to test this in a clinical trial.

Dr. Bruce Walker of Massachusetts General Hospital in Boston said he had a patient who would try, and a team at the National Institutes of Health (NIH) in Bethesda, Maryland, said they were also planning a trial in the next month or so.

"There certainly have been anecdotes of people going off therapy," Dr. Anthony Fauci, head of the National Institute of Allergies and Infectious Diseases (NIAID), one of the National Institutes of Health, said in a telephone interview.

"This will be the first person in a study, in a protocol."

In 1996 AIDS researchers announced that a three-drug cocktail could knock the virus down, and said they would take patients off the mixture after 18 months of treatment. But it soon became apparent that the virus still lurked in "reservoirs" in the body, and would bounce back as soon as the drugs were stopped.

But now some patients have been on the treatment, known as highly active anti-retroviral therapy (HAART), for years. And there are many more drugs on the market that may better suppress the virus.

European researchers say three patients who have taken a cancer drug known as hydroxyurea along with regular HIV drugs have been able to stop taking all the drugs without getting sick again.

Fauci said taking patients off the drugs is the only way to see how long patients have to stay on HAART.

"It depends on the status of their immune system," he said.

"If their immune system is capable of containing the virus... it's certainly possible. The only way you can find out is to ask the question." The experiment is not without risk. "I think that this certainly is taking a chance," Fauci said. But he said if the virus comes back, the volunteer can go back on the drugs.

"The chances are that he could get it back suppressed again," Fauci said. He said patients who stopped taking their drugs because of the dangerous and unpleasant side-effects could go back on the same drugs, which usually did not lose their potency against the virus.

But HIV patients should not try this on their own, Fauci stressed. "Absolutely not," he said. "It would not be appropriate for patients on their own or for individual physicians to just stop therapy on people."

Fauci said the NIAID's Dr. Cliff Lane was currently seeking approval for a trial similar to Walker's, which could start as soon as next month.

"It would be taking people who are on therapy for variable periods of time who have undetectable virus by standard measures, and randomizing them into either stopping therapy or continuing therapy," he said.
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