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A Break from HAART!!
Mar 26, 2002

Dear Dr., I have been on HAART for nearly 5 years when hit hard and early was all the rage. I recently stopped 3tc, efv, and viread. I believe I have some resistance to either or both efv, and 3tc. My last labs were cd4=724 and VL=2300 while on the meds. I told my Dr. I want to have a genotyping test when I do my next labs so I dont risk a mutation to Viread. What are the guidelines for someone like me as to when to restart meds? How long can I stay off. My T-cells have never gone below 500, but my VL tends to get high off drugs. I dont think I have ever reached a set point on the VL, since I started treatment within the first several months of my HIV infection. Thank-you in Denver

Response from Dr. Boyle

If your viral load was detectable on your last regimen, you should have had a resistance test performed while on therapy since reversions back to wild-type may occur within a few weeks to months of stopping therapy. I would encourage you to get the resistance test done ASAP. As far as how long you can stay off therapy, I would monitor your CD4 count and consider restarting whem you got to around the 350 area (or so, depending on how anxious you were to restart therapy). Since your CD4 count has never been below 500, it may be sometime before you have to restart, but you should be monitored carefully.



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