Question

Hello Doctors:

I am having serious pill fatigue. My viral load when last checked was 5600, down from 550,000+ and my cd4 was 205, up from 31.

My doctor has taken me off zithromax and will be taking me off bactrim so that will be two less pills. However, I am finding it difficult to take all the others every day, sometimes I forget (due to my hiv dementia compelx), and other times I just space. I have done pretty good but I know I have been missing a few here and there.

Is it safe to go off all meds for maybe 3-6 months and then re-start? Or would I just be doing myself more harm?

Thank you for your input.

Answer

Most of the studies that have looked at treatment interruption (taking a vacation from your anti-HIV pills) have found significant risks with this practice. Two studies (the SMART study and the DART study) were stopped this year when it became obvious that those in the study who had periods of time off treatment were significantly more likely to developed AIDS-related illnesses.

Your experience of pill fatigue is understandable. However, if you stop for several months, then you will expose yourself to the risk of an AIDS-related illness. Maybe, an alternative would be to talk to your doctor about whether there is a way to reduce the number of pills that you have to take.