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Can I take a Break from Meds?

Mar 27, 2005

Thanks for the great resource!

I've been positive for 5 years and currently (past 3 years) take Kaletra, Viriad, Videx, and AndroGel. I find most bothersome the residual shingles pain, diarreah, fatigue, depression (citalopram), anxiety (lorazipam), and some blurred vision from "enlarged optic nerves" there are other, more tolerable, side affects.

My CD-4 count is 490 and my viral load is <500, it always has been between 200-500 while I am on meds. I would like to take a break from meds to make school more manageable but have been told that because my CD-4 count was at 200 prior to treatment it is not recommended and if I do, the next treatment may not have optimal results. I have resistance only to the first drug I was on, Combivir, which was discontinued due to liver problems, which have since resolved.

Response from Dr. Pierone

One of the reasons that we stop therapy is to manage side effects. The regimen that you are on is very potent, but certainly has its share of potential toxicities. It is not unreasonable to stop medications to see how you do off therapy. There is no reason that you would not have optimal results when you restart therapy, the main risk is that you may not be able to stay off for a prolonged period of time since the nadir CD4 count was around 200. When it comes time to restart (could be very soon or after one or 2 years) you might try a different regimen to minimize toxicity. This depends on previous resistance tests and what medications are available when you restart. Hope this helps and best of luck.

long term non-progressor
CBS interview: Dr. Ho/Dr. Markowitz study of cyclosporine in HIV treatment

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