View Full Version : Italians are SMART(er?)

July 9th, 2009, 02:48 AM
This could be a significant study concerning HAART. (http://www.medscape.com/viewarticle/703720) (link updated)

It compares continuous treatment with cd4-based scheduled (or structured) treatment interruption (STI). The result: equivalent outcomes.

Besides the SMART trial, LOTTI is the largest controlled trial ever performed on CD4 cell-guided STIs. The total follow-up time was greater than 1300 person-years, and the mean follow-up time of our patients was 51.3 months compared with 20.7 months in the Staccato trial, 20.4 in the Trivacan study and 16 months for SMART. A longer follow-up increased our chances of observing slow to manifest or chronic clinically relevant events.
In this study, the primary end point was a composite clinical outcome comprehensive of the occurrence of opportunistic diseases, death from any cause and diseases or manifestations requiring hospital admission. This choice was based on the fact that the STI strategy, to be considered equivalent to continuous HAART, should not just prevent death or progression to AIDS, but should ensure a good health status, too. According to this end point, we documented that the STI strategy was clinically noninferior to continuous HAART.
Most of the measures and outcomes are based on cd4 counts and viral load, of course, but one significant finding jumped out at me, and it reflects my own personal experience: a lot of participants (45 of 165) who quit their cocktail never had to go back on the drugs!

I'm guessing others here will uncover some other tasty tidbits.

July 9th, 2009, 11:15 PM
I just get a log-in page for Medscape when I click on the link. Can you paste more of the study text here please?


July 10th, 2009, 02:02 AM
The study is presented in four parts. I'll copy/paste is necessary, but it would really be a lot of text.

Would someone try copying/pasting the URL below first:


July 14th, 2009, 02:38 AM
I just blogged (http://resistanceisfruitful.wordpress.com/2009/07/13/take-a-vacation-from-aids-drugs/) about this study, and posted a youtube video (http://www.youtube.com/watch?v=8j1RwNj-m24&feature=channel_page) on the same material. The more I read and thought about it, the more important I think these results are. Feedback and comments are welcome, of course, either here or there.

I've no doubts that some here may find fault with both the study (it uses cd4 counts as markers of "disease progression", for example), or with my own analysis. I hope I write in a way that most of my "poz" friends might understand, because they are the audience I care about the most. They are not aware of the many nuances used among more experienced dissidents/questioners.