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Can I Stop My HIV Medications and Take a Treatment Holiday?

Are HIV Treatment Interruptions a Good Idea?

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Updated December 22, 2010

An anonymous user writes:

"I have HIV and my current CD4 count is at 320. I was diagnosed this past March with this disease. I was wondering if it's possible for a person to go off of their meds for HIV providing that of course it hasn't become full blown AIDS?"

Your HIV Guide responds:

Based on small, non-randomized studies, experts initially felt that a structured treatment interruption; meaning a person takes short breaks from their medication; was not a bad idea. However, further study determined that indeed, structured treatment interruptions actually were detrimental to a person health. Two large, carefully planned studies known as The SMART and the DART studies have revealed the treatment interruptions are an unsafe practice. The SMART (Strategies for the Management of Antiretroviral Therapy) studied the effects of treatment interruptions in disease progression in more than 5,000 patients from 33 countries. The study was halted early because data showed that those people who underwent planned treatment interruptions when their CD4 counts were higher than 350 were twice as likely to have their HIV progress and die than were those people being on meds continuously. Those people interrupting their therapy also had a higher incidence of adverse events like cardiovascular disease such as stroke or heart attacks than those taking meds without interruption.

A second study, the DART (Development of Antiretroviral Therapy in Africa) study compared HIV treatment interruptions to continuous therapy in more than 3,000 people with a CD4 cell count of over 300. Patients were randomized to either receive continuous HIV treatment or to take twelve-week cycles of HIV treatment followed by twelve-week breaks. However, the treatment interruption arm of the study was stopped early and all patients advised to switch to continuous treatment when the researchers noticed that people in the treatment cycle arm were more likely to develop HIV-related illnesses.

So after initially thinking treatment interruptions were safe, the data now shows that treatment interruptions are not safe and should not be done.

Important Warning!
NEVER stop your meds without discussing your reasons with your doctor. There may be medication options that are more suited to your needs and abilities. Stopping without consulting your doctor can be very harmful to your health.

Source

National AIDS Manual (NAM); "Fact Sheet 51: Structured Treatment Interruptions"; AIDSmap.com; May 2006.

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