Long Term HIV Drug Adherence
Jan 22, 2014
I was diagnosed with hiv 14 years ago with a viral load over 100,000 and a cd4 count of 25. I have been on various drug regimens, most which have resulted in severe side effects such as daily headaches, nausea and vomiting. My current regime is Isentress and Truvada which I have been on for the past 5 years. To minimize side effects, I take these drugs for two weeks, then skip two weeks. I have done this for the past 4 years. My viral load has remained undetectable and my cd4 count has stayed between 350 and 400 throughout this 4 year period. My physician has advised against this. Am I playing russian roulette or can this work long term? I am currently 52 years old.
Response from Dr. Henry
Intermittent treatment such as you describe is not recommended. Two of the three drugs in your regimen have a relatively low barrier to resistance (the raltegravir and emtricitabine) and once resistance develops it is permanent and would compromise future treatment options for you (all future treatments would be more complicated with likely even more side effects). Careful monitoring for side effects (including lab monitoring) is generally very effective at detecting early side effects that would be a concern and would merit a change in regimen if due to one of your HIV drugs. KH
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