computergeek
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Your US/Canadian treatment biases are showing.on-hold said:Though I agree wholeheartedly with the sentiment expressed here about taking medical advice, I still want to point out that what I said is an accepted fact, and not one that will vary depending upon doctor or country -- there is no standard treatment regimen that involves beginning ART and then quitting, and suggesting this as a possibility would be ridiculous (I know the poster did not).
LOTTI study: http://www.medscape.com/viewarticle/703720 - it reaches a different conclusion and is used in some countries clinical practice to guide treatment strategies.
MONET study: http://www.natap.org/2011/IAS/IAS_61.htm - this treatment paradigm uses a full course of treatment but then removes some of the drugs and relies only on the boosted PI (darunavir/r) after certain thresholds.
Neither of these are practiced in the US or Canada, but both are practiced in Europe.
In my experience, Europeans are much more flexible when it comes to exploring variations in the treatment paradigm.
There is a wealth of work being done in looking at alternatives as well, including the recent Australian results (1/3 decrease in efavirenz is equally effective, for example, and thus presumably this will help cut treatment costs) and other useful studies on decreased dosages (http://www.ncbi.nlm.nih.gov/pubmed/20046153).
It's great that Canada pays for these drug costs, but they do serve as a barrier to immigration. Thus, looking outside the "accepted practice" is useful for understanding acceptable but less expensive treatment paradigms.