Drug Holiday

Most AIDS patients taking cocktails of antiviral medications pay dearly. Not only do the dozen or so pills they must swallow each day cost a fortune–up to $10,000 a year–but they also cause terrible side effects: nausea, vomiting, fatigue and unsightly fatty deposits in the upper body. So it’s not surprising that some patients slip from time to time and take what they call drug holidays.

The problem, of course, is that HIV takes no such breaks. When the pills stop, the virus roars back–except sometimes it doesn’t. Last week researchers at the Aaron Diamond AIDS Research Center reported on four patients who started taking cocktail therapy early and then took a cocktail break. In two of the patients, the virus rebounded and remained at high levels until they went back on their medications. But in the other two, intriguingly, the virus spiked briefly and then went into hiding–staying below detectable levels for at least 14 months.

While patients like these are rare, their cases raise interesting questions. Could it be that the HIV spikes function as booster shots, priming the body’s immune system to rally against the virus? Already, several aids-research teams have begun systematically weaning a few patients off their cocktail therapies to see whether the brief drug holidays might somehow be stretched into a permanent vacation.

–By Alice Park