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To continue Meds or Not?
Sep 22, 2004

Hello: If you have been treated on the theory of hit it early and hard with meds and you are doing great on meds with no reactions and counts are at vl 0 and cd4 1000, would it make any sense to stop? Or continue for as long as the meds are working? Being he is 21 and his immune system is strong which direction would you advise, staying on meds or coming off and seeing how his numbers react?

Response from Dr. Wohl

I think much depends on what was the young man's CD4 cell count and viral load at the time therapy was began. If he was initiated on therapy in the heyday of 'hit hard, hit early' at a CD4 count much above 350, there is a rationale for stopping therapy and watching the counts closely.

If the viral load was very high, enthusiasm for stopping might be a bit tempered as the CD4 count would be more likely to plummet after treatment cessation.


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