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A follow-up question, please?
May 18, 2003

Dear Doc Holodniy,

Thank you for your prompt reply. May I please be permitted a follow up question? You wrote, in part: "Given what your baseline viral load before treatment was, if you were to stop treatment now, we would expect your viral load to come back up to those levels and probably not much higher." As a refresher, my VL was approaching ~ 8,500 when HAART was initiated in 1999. Okay, so what's the downside -- if any -- to letting the virus run amok at this or a slightly higher level? The benefits to even a temporary cessation to treatment is obvious, but I fear letting that virus loose. Your opinion will help me with this. Many thanks again!

Response from Dr. Holodniy

The down side is that you now have active replication going on, as indicated by a detectable viral load. This means that t cells will begin to get infected again and be killed off, losing certain aspects of your immune system. You won't know the kinetics of this destruction rate until a few months after stopping and following your numbers.



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