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structured interrupted therapy

Sep 13, 2001

I really feel that I would like to take a break from my therapy regime. I see some lipodistrophy in my face. I really feel that I don't have many other side effects but would love to take a break. My father died of heart disease at 68 yrs. old. I have elevated cholesterol from the drug regiment. I also have been feeling that my breathing has been somewhat labored and shallow for the past year. I have an undetectable viral load since beginning the drug cocktail. My doctor doesn't suggest the break but will support my decision. Help!

Response from Dr. Boyle

Taking a break from your medications may be alright under certain circumstances, and not alright under others. If you started antiretroviral therapy with more than 350 CD4+ T cells/mm3 and no evidence of problems related to HIV infection or history of opportunistic infections, I do not have a problem with your holding the medications while being carefully monitored. If you have had or are having metabolic problems related to the antiretrovirals, I would be even more strong in my support of your decision to take a break under these circumstances. On the other hand, If you started with fewer than 350 CD4+ T cells/mm3 or you have ever had any evidence of an opportunistic infection or other HIV-related problem, I would discourage taking a break since you can return to your CD4+ T cell nadir and viral load peak relatively quickly off therapy and run the risk of more HIV-related problems or opportunisitic infections.

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