Drug Holidays: Are They Worth It?
People with HIV sometimes complain to me about severe side effects from antiviral medications (also known as "drug cocktails"). Some have wondered if the benefits of these drugs were worth the side effects. In many (but not all) people, these drug cocktails have been shown to be very helpful in improving their clinical status. But are these benefits worth the nausea, vomiting, fatigue and other side effects that sometimes occur? People suffering from severe side effects must ask themselves, "Which is more important . . . quantity of life, or quality of life?" Ultimately, this balance between quantity of life and quality of life is a very personal decision.
Some people who suffer from severe drug side effects stop taking their drugs (either temporarily or permanently). They may skip a dose or two, or just stop taking their drugs altogether. This is commonly known as taking a "drug holiday." Depending on the circumstances, clinically speaking, this may be very harmful to someone with HIV. Here are some reasons:
Generally speaking, once someone starts treatment, it is strongly recommended that they continue treatment indefinitely (although they may be able to switch from one drug cocktail to another). If someone's side effects are so severe that their quality of life is significantly reduced, there are several options:
My best suggestion is for people to discuss concerns with their doctor before making any changes in treatment. Living with HIV is a balancing act between quantity of life and quality of life. Only the person living with HIV can decide where that balance lies.
For more information on treatment guidelines, see the following:
Remember that treatment guidelines are changing very rapidly. Therefore, some information may have already changed by the time they are published. Also, opinions regarding when to change treatment (and what treatments to change to), vary from one HIV expert to another. Simply put, when it comes to treatment issues, this is a topic where one question can have many different answers (and opinions), depending upon whom you ask, so always consult with your doctor.
These same issues, of quantity of life versus quality of life, can be found with any other chronic and life-threatening disease. People with cancer must ask themselves these same questions, especially as they relate to the side effects of chemotherapy, radiation therapy, surgery, etc. So the options discussed above apply not only to those being treated for HIV, but for people with other life-threatening illnesses as well.
Do you want more information on AIDS, STDs or safer sex? Contact the U.S. Centers for Disease Control AIDS hotline, open 24 hours a day, seven days a week, at 1-800-CDC-INFO. Or visit The Body's Safe Sex and Prevention Forum.
Until next time . . . Work hard, play hard, play safe, stay sober!
This article was provided by Rick Sowadsky, M.S.P.H..