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time between hiv treatments
May 30, 2013

Hey There

I was wondering if there is a study to determine the time between treatment that brings a person from the high viral load and cd-4 count being to low been returned to near normal with very low to undetectable viral load and then when meds were discontinued how long it took for the high viral load and low cd-4 count to occure. if the first answer is 2 months and the second answer is 10 years then the following can be said : monthly cost for ARV 1000$+ by 120 months or 120,000$ over curtrent life expectancy, This could be reduced to a 2 months treatment of 2000$+ to reclaim the victum from the jaws of death then save the other 118 months from meds which would result in a 100,000$+ saved per patient and it would reduce likelihood of drug resistence, and if it works increase lif expectancy to normal with the periodic treatments on a 2 month per 10 years? I have tried to explain here why I want to know if there have been studies to determine the time between high viral load/low cd-4 count and treatment that brings back to low viral load count and high cd-4 count and how long before returning to high viral loads and low cd-4 counts if meds were discontinued after the first series of treatments

Response from Dr. Henry

The SMART Study examined effect of stopping effective HIV treatment in setting of CD4 counts > 350. The study was stopped because the group stopping HIV treatment faired poorly (clinically from events including death, heart disease, cancer, and AIDS) compared to continued therapy after only about a year average off meds. Also, stopping meds leads to generally prompt viral rebound to pre treatment levels often within 6 months with greatly increased risk of transmission to other persons and a drop in CD4 count that is greater then the increase seen when back on treatment thus the concept of on and off treatment has been tried and overall deemed a failure. KH



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