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ATR the 3 in 1 Pill
Sep 19, 2006

Is it possible that I will ever stop needing the pill if I continue to do well?

Response from Dr. Sherer

No. It is a certainty that, once HIV infected, you will remain HIV infected. And once you have become a candidate for ART, you remain a candidate for ART for the rest of your life.

There is one possible exception that may still allow you some time off of ART. Some physicians have allowed patients with high CD4 cells, e.g. over 500, and well-controlled viral loads, eg below detection, to temporarily withold treatment and undergo a 'drug holiday' until their CD4 cells return to a level at which treatment should be resumed, eg less than 350 cells/ml. There are a few clinical trials that suggest that this can be a safe practive for some patients.

You should be aware, however, that the above strategy has also been shown to be worse than staying on ART in some clinical trials, eg in strategies where the CD4 cell count was allowed to return to a lower threshold, e.g. < 250 cells. In those trials more people developed AIDS or became sick for other reasons when they stopped their ART. In addition, there is always a small risk that stopping ART for any reason will cause a recurrent acute antiretroviral syndrome with fever, rash, fatigue, and even encephalitis.

So the safest practice appears to be to simply remain on ART once it is begun.

Most importantly, as well, is the need to maintain excellent adherence for as long as you are on treatment by not missing any doses of the entire regimen. Thankfully this is a simpler matter with Atriple, the new co-formulated pill once daily containing efavirenx, tenofovir, and emtracitadine.

I suggest that you talk to your doctor about this question and this answer.

Poor adherence
cd4 count less

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