Cytokine therapy or structured treatment interruptions in HIV infection: which is best?

Abstract

Continuous highly active antiretroviral therapy (HAART) is the treatment of choice for HIV patients in order to prevent opportunistic infection or AIDS-related morbidity and mortality. However, new HIV treatment strategies are needed to face the emerging problems related to long-term toxicities and failures of HAART. Moreover, total eradication and complete restoration of immune system function cannot be achieved by HAART alone. Therefore, in an attempt to increase the natural immunity of HIV-infected patients, immune-based therapies have been investigated. This review is intended to provide an update on the use of immune-based therapies, in particular structured treatment interruptions and cytokines, such as IL-2 and IFN-alpha, as potential stimulants of the immune system of patients with HIV-infections and to discuss risks and benefits of each alternative. Ongoing and future clinical trials will provide a rationale for their use in clinical practice and will determine how these strategies can be combined to optimise HAART.