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Drug Holiday
Jun 10, 2006

Just wondering about stopping meds during an overseas holiday, just for 14 days. Is this going to cause problems or is it only longer breaks that have issues. undectable vl and very high tcell count.

Response from Dr. Daar

Thank you for your post.

The decision as to when and if therapy can be safely stopped for 14 days when viral load is undetectable is complex. I would encourage you to talk in advance with your provider to discuss the necessity for this and if you do choose to do it the safest way to proceed. The greatest concern is in those on nonnucleoside reverse transcriptase inhibitors (NNRTIs) such as efavirenz (Sustiva) or nevirapine (Viramune). In this setting some recommend stopping the NNRTI for days to even weeks before stopping the nucleoside reverse transcriptase inhibitors (NRTIs). Others suggest switching the NNRTI to a protease inhibitor for some period of time before stopping all drugs simultaneously. However, these are just suggestions since no definitive data exists for the optimal way to stop NNRTI-containing therapy. Thisis why any decisions regarding stopping successful therapy needs to be carefully thought through in advance and coordinated with your primary provider.

Best, Eric

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