Who Conceived of and Carried Out the SMART Study?
The researchers for the SMART trial were from Community Programs for Clinical Research on AIDS (CPCRA) — the National Institutes of Health-funded HIV research association that was organized to conduct community-based trials. CPCRA is separate and distinct from the AIDS Clinical Trials Group (ACTG) sites, which are predominantly based in academic institutions. When the SMART trial was designed and promoted, there were some conservative voices in the HIV research establishment opposed to the notion of a treatment interruption trial of this nature. It was not unusual to hear statements to the effect that the SMART study was “anything but smart.” This seems extremely unfair since the SMART study represented a significant departure from the “business as usual” thinking in the somewhat entrenched and slow-moving HIV research establishment. Clearly, important strategic treatment studies that involve limiting therapy will only be performed in the context of government-supported research. Indu
