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Is stopping therapie a good Idea
Jan 16, 2001

Dear Doctor,

i am very happy that I dont have to bother you with some more of the serious problems associate with HIV. I was infected in 1996 and diagnosed with HIV infection in 1998. My numbers where then VL 55000 and T4 465. I have been on combination treatment ever since very religiously. My latest numbers where VL below 50 and T4 over 1000. I never had really any health problems so far. My appetit has been lousy for a while but this resolved itself by getting some testosterone shots. The only thing which has been bothering me are some bodily changes like thinning of face and loss of buttock. I switched d4t and 3tc to combivir(AZT) about 2 months ago. My question to you is this. Would it be reasonable with my numbers to stop therapie completely for about a year or would I loose my benefits regarding health in the future once starting again. Also could i expect my cd4 counts to go up again to the range where I am now. Your expertise would be appreciated. It is a very difficult decision to make but i also feel my body needs some rest from all the toxic medicine. thanks you very much


Response from Dr. Feinberg

There are ongoing studies of people like you whose virus is well-controlled and who have had a good T cell response to therapy, to see if these benefits can be maintained if therapy is stopped and then restarted. So far the data are iffy. For most people, viral load goes up when the medicines are stopped, and if resistance has not developed, will fall again when medicine is restarted. No one knows yet what the long-term effects of such a strategy are. In my experience, if you stop all your medications and then restart at some point before your viral load and T cell results are worrisome, you are likely to regain full suppression of your virus and will have a T cell response as well. But I cannot tell you whether your T cells will increase to 1000 again.

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