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Will you comment?
Aug 27, 2002

Doctor Bob, You are probably the best person to ask as you are a member of the hiv brotherhood and you are also a doctor so you are "in the know" all the way.So I will ask this.How do you feel about structured treatment interuptions personally.Did you ever or would you ever? I'm about to start mine with my doctors close monitoring and I am so nevous.I have really wanted to do this for SO LONG and we have made lots of preparations and plans, strageties in case of this or that,yet after all of this I still feel nervous.I'm in a safe place to be trying this, but I know with hiv you can't predict anything.So how do you feel about carefully planned interuptions?Thank you

Response from Dr. Frascino

Hi,

We still have much to learn about structured treatment interruptions. There are various potential reasons to consider an STI, including the following:

1. immune enhancement of CD4-specific anti-HIV responses, if used during recent infection. 2. Medication fatigue or medication toxicity. 3. attempts to encourage resistant HIV to revert back to "wild type."

Certainly the days of a "drug holiday" just for the hell of it are over. Closely monitored STI's instituted for a specific reason are now being actively studied in a variety of different clinical trials. The results so far have been mixed. Would I recommend one for myself? No, not at the moment, due to my personal immunologic profile, past history of taking certain medications, and current laboratory values. Would I recommend an STI for you? I really can't say without knowing much more of your history, laboratory values, medications tried, side effects, and reasons for attempting an STI at this time. It sounds like you and your physician have carefully considered the risk-benefit ration, and made contingency plans for possible outcomes. That's essential to avoid unpleasant (and often unnecessary) surprises! If you want to send back additional details, I'll try to give you a more specific response. Either way, yes, we are all in this together and I as well as all the readers of this forum will be sending you good karma in hopes that all goes well.

Keep us posted!

Stay well.

Dr. Bob


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