Question

Dear Sirs, I am HIV positive since 1992 (first test). In 2008 my doctor suggested that I should start medication due to T cells count around 200. Since 19-02-2008 until today I am taking Atripla. I have absolutely no side effects other than I having gained weight and rare vivid dreams. If I would stop taking medication now, would would happen? Would you share your opinion on the fact that HIV does not cause AIDS and in vitro it was never achieved to extract the virus? What is your opinion on the HIV test? Can the outcome not be different every time because there is no standard? Thanks so much for your time,M.

Answer

Stopping effective HIV medications when the starting CD4 count was around 200 generally results in a return over 3-6 months of viral levels similar to the pre-treatment levels and a decline in the CD4 count (rate is variable from person to person). The SMART study was a large clinical trial looking at the effects of continuing HIV meds when the CD4 count was > 350 0r stopping meds and then restarting them when the CD4 count fell to < 250. The study was stopped due to higher rate of deaths, AIDS, and disease (including heart disease and cancer) the the group that stopped or was on intermittent treatment. The date that HIV causes AIDS is very convincing. The year in my clinic that effective drugs targeting HIV were available, the death rate dropped 90% from the year before and scores of patients who were near death recovered (only treating pxs with the meds who were HIV positive)-it was amazing to think back how terrible things were in the first 15 years of the epidemic. KH