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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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stopping after starting

Mar 4, 2005

Is it true that once started, treatment can NEVER be stopped? If treatment reduces the viral load to undetectable levels, wouldn't the immune system bounce back over time so that you could go off treatment again at some point?

Response from Dr. Henry

HIV meds can be stopped in a number of situations. The safety and wisdom of stopping HIV meds has not been fully evaluated. If the CD4 count has never been < 250-350 stopping meds is safer. Stopping certain meds runs the risk of resistance developing (especially drugs liek Sustiva which persist in the blood for weeks and only one mutation needed for resistance) so stopping needs to be done skillfully. The SMART study is comparing the strategies of continuous HIV treatment versus CD4 based starting and stopping (will be many years before we really know the clinical outcome of that study). KH

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