Question

Why is STI considered a scientifically controversial strategy? Suggest three biological reasons why STI could be advantageous. Predict what will happen to the virus over time if patients are then allowed to resume their HAART therapy after STI. Propose situations in which the STI approach may not be recommended or effective in some HIV-positive people. How would a physician be able to tell if STI is working?

Answer 1

STI stands for Structured Treatment Interruptions (STI). It is methodology to exempt the patient from regular medical prescription. This is specifically used in treating patients having HIV in order to release them for a fixed time from taking heavy antiretroviral therapy. STI is controversial because of high probability of rebound of diseases and its clinical progression. The CD4 cell count will also decline.

Three advantages of STI

- assess the functionality of natural immune response to the HIV virus

- reduce the toxicity of drugs

- restore viral drug susceptibility

Resuming HAART after STI reduces the load of virus as it restrict creation and synthesis of viral DNA. There are high probabilities that continued medication can make the virus resistant against the therapy and regular medicines. The disease impact will reduce when the virus become resistant to the drugs.

STI cannot be used for chronically infected individuals as they tend to have high replication of the virus on being exposed to STI.

Ways to test STI

- Through regular physiological measurements

- Keeping a count of CD4 cell count

- Keeping a check on plasma viral load levels