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Editorial: Freedom of choice
| Last updated: 27.10.04 |
It’s ironic that whilst the main focus of this month’s XV International AIDS Conference in Bangkok is on finding ways to get everyone with HIV onto HAART, treatment interruption has become a hot topic in well-resourced countries, as resistance and side-effects are increasingly recognised as issues in managing HIV disease.
Currently, the largest-ever clinical endpoint trial in HIV medicine is recruiting people at all stages of HIV disease in order to ascertain if cycling on and off therapy at pre-determined CD4 levels is better in the long term than staying on HAART. The possible risks and benefits of this strategy are critically reviewed in ‘Interrupting Smartly’.
Meanwhile, ‘Supplemental Review’ features a study from last year which found that a multivitamin supplement costing just US$1 (60p) per month significantly increased survival in people not on HAART who had CD4 counts below 200 cells/mm3. In the UK we have, on the whole, good nutrition and clean water; we are free of endemic disease, war and famine; and we have access to HAART if we want it. Our review concludes that taking vitamins might be a useful adjunct to our current therapeutic choices. We are very fortunate to have those choices.