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Forced to stop treatment

Oct 15, 2011

I am 35 y/o and I am in Buenos Aires, Argentina. I was diagnosed with HIV within 6 months of the infection, in December 2009 and I decided to start treatment right away. By then I was living in NYC with my partner and I may go back within a few years. The decision of starting treatment right away was mine, by then I didnt know what the future could hold. When I was diagnosed my CD4 count was 600 and my viral load 7,000. My genotype showed that my virus was sensitive to all treatments and I started with Atripla. Ive been undetectable since February 2010 and my CD count has always been above 800. I have no had side effects besides the reactive depression that usually follows bad news like becoming HIV positive My relationship ended and I moved back to my native country, Uruguay. I will no have access to Atripla until mid 2012 because of medical insurance issues. My question is: in my particular case, what would be the risk of interrupting the treatment and being under control versus keeping taking Atripla until I can get the medicines by my local insurance? In other words, what would be the impact on my immune system of stopping the treatment for about a year under medical care and resuming it when my medical insurance issues in Uruguay have been solved? I read that there is an ongoing clinical trial that will enroll patients who have been undetectable for a year to conduct a structured treatment interruption, is that true? How big are the odds that I would develop resistance to any of the drugs? Thank you very much for your time.

Response from Dr. Holodniy

In almost all cases, stopping HIV treatment will result in the viral load becoming detectable again, and over time, the CD4 count would begin to decline. However, given where your current CD4 count is, the risk of CD4 decline when stopping treatment for a few months is likely to be very low. the likelihood of developing resistance is very low.

Gero Hütter

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