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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
           
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sti JB
Nov 10, 2000

i quit meds apr 9 this year. i was interested in the kind of sti where u quit and stay off the meds til your numbers go bad. i also followed the other sti studies and told my Doc that those will cause resistance and the one where you stay off til you need meds again made more sense to me. well i'm in my 8th month off meds. i will admit it has been a rocky road for me. from month 2-5 i went into a huge chemical imbalance, complete with panic attacks that lasted a couple of hours. i was beginning to wonder if quitting was such a good idea. well, my doc decided that it must have been my liver causing this imbalance. i went to acupuncture and they needled my liver for about 6 weeks. the panic attacks stopped immediately! and the depression slowly went away. i feel great now. and get this, my t's are at 626! but my viral load has slowly climbed, now at 39,000, which ain't bad. i started with 900 t's and vl <25. the lowest was 450 t's and the lowest viral load, month 3, was 23,000. i think you doctors have scared too many people into stopping meds. i have friends suffering from side effects that have t's as high, if not higher, then mine were. their viral loads are all undetectable. why do you do this? why do you scare them into staying on meds? you recognize the need to get them off, yet you all terrorize them into staying on. why? i am not some super human, or even slightly special, and i am doing very well off the meds. other people should do as well if not better. so why aren't you telling these people with t cell counts 900 or 1000 or more, and undetectable viral loads, that they can quit for awhile? what about quality of life? doesn't that fit in with your number crunching? if you want to ask me any questions about this time off meds, please do.

Response from Dr. Bartlett

Structured treatment interruptions have attracted great interest over the past year. The final results from careful studies simply are not yet available. In general terms, it appears to be important to separate newly infected patients on therapy from patients who have been infected for >3-6 months. Newly infected patients on therapy may benefit from STI, but the available results are far less encouraging for other patients with established infection. In some patients, quality of life may improve during off treatment periods, and you have raised an important issue. It underscores the need for patients and their health care providers to work together to have a clear goal for treatment. However, I would be very cautious in recommending stopping treatment without a careful review of the options.

John A. Bartlett, M.D.



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