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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Is Decontamination from Meds an alternative?
Jan 7, 2006

Hello, I was wondering about something my doctor mentioned the other day. Right now I'm on HAART and it has been working very well, never switched treatment or anything. I am a bit worried about long-term side effects, specially for AZT. My doctor did mention once something about a decontamination from the drugs, as in suspending them for a while and then going back, however he has never mentioned it again. I do believe I read something similar in a Kaise Network newsletter, though i haven't been able to find it. I was wondering if this was possible? I hear that sometimes people get terrible diseases from their meds, so I was wondering if a certain "cleansing" from time to time would prevent wasting. What would you think about suspending a therapy and then restarting it when, for example, viral load goes up again? I am also concerned about becoming resistant to the meds. Do you know anything about these practices?

Response from Dr. Henry

Stopping HIV therapy is not recommended for persons with a history of AIDS (clinical or CD4 count < 200) due to risk of rapid loss of CD4 cells and clinical events. If the CD4 count has never been < 350 then stopping treatment is often well tolerated. Newer HIV regimens seem less toxic with less of a perceived need to stop to allow for reversal of even hidden side effects. Stopping HIV therapy usually leads to prompt return of HIV to pre-treatment levels and a drop in the CD4 count. For some regimens stopping HIV meds can increase the risk for resistance so even stopping meds can be somewhat tricky. In general patients who are doing well on HIV treatment (virus suppressed with a good CD4 count such as levels >> 350)can expect to remain healthy from the HIV standpoint for many years/? decades). Tweaking a given regimen to make it safer/easier/less toxic is a common practice in regions of the world with access to all/most of the available antiretroviral medications. KH

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