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drug holiday for training gains?
Apr 27, 2005

Hi my question is this. I have been poz for 16 years and doing great I have been on meds for 10 years with one holiday. wondering if with a cd4 of 540 and undetec viral load. Will it be better to train for cycling this summer off my meds. I seem to think the drugs impead my ability to recover and build muscle that i need for strength in cycling. Would a closely watched holiday help my training?? Any advice would be greatly equals close to 200 plus miles of riding a week.

Response from Dr. Sherer

There is no specific evidence that I am aware of that would support a drug holiday for this purpose.

I would discuss the possibility with your physician, and decide on your best course of action together.

To consider this question, I would want to know your treatment history, and your responses; your baseline CD4 cell count and viral load, their highest and lowest values; the course of your one drug holiday (and the regimen you were on at the time); and a great deal about you and how you would approach a second drug holiday.

I would also want to know how you have handled bicycle training up to this point, and what the outcome was. Is there a reason that you want to train while off meds? Have you trained before while on meds?

I would add that the strategy you are suggesting, i.e. temporarily stopping ART at a point when your CD4 cells are above 500 and your viral load is well-controlled, is the only setting in which I would consider advising a regimen holiday. We really don't know whether a person's adherence changes following drug holidays, for example. I am very conservative on this issue, and I tend to err on the side of maintaining an excellent treatment record (such as you have had).

And, as always in this forum, I would remind the readers that a single internet opinion can't compare with the advice of your own physician, who has all of the above information, and more that I haven't mentioned.

Good luck with the training, which ever way you and your doctor decide to go.

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