NAPWA

There has been considerable research into the effects of stopping anti-HIV treatment for periods of time, often called ‘structured treatment interruptions’. When treatment is stopped, viral loadA measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. begins to rise and CD4 cell counts fall. Recent research has shown that if your CD4 cell count is in the vicinity of 250-350 stopping therapy significantly increases the risk of having an AIDS-defining illness or dying. In addition, taking treatment breaks may in fact increase, rather than decrease the risk of side effects, including serious side effects such as heart attackA life-threatening emergency in which the blood supply to the heart is suddenly cut off, causing the heart muscle (myocardium) to die from lack of oxygen. and stroke (cardiovascular disease).

There is also a risk of developing drug resistance if you stop taking drugs in an unplanned way, as HIV drugs stay in the body for varying periods of time (nevirapine and tenofovir, for example, stay in your body for a long time after dosing with levels dropping very gradually). If you have only one drug in your system, you are applying selective pressure to HIV that quickly results in resistantHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. strains emerging that can affect your response to drugs in the future.

If you are experiencing side effects

If you are finding treatment side effects very unpleasant, you may be considering stopping or changing therapy. Research now indicates that stopping treatment should be a last resort that might further damage your health.

Some side effects are most pronounced for the first weeks of taking a particular treatment, some are persistent, and some emerge over time (abnormal fat metabolism), so it is important to determine where your particular side effect fits into this scheme, to work out how best to deal with it.

Stopping therapy and then re-starting with the same agents is unlikely to be an effective strategy with any side effect, and if it is the kind of symptom that tends to disappear over time, it will worsen the problem.

For side effects that emerge in the long term, such as changes in fat metabolism and body shape, taking a short pause in therapy is not going to reverse the conditions and taking a longer treatment break could be very dangerous for your health. Substituting other ARVA medication or other substance which is active against retroviruses such as HIV. drugs is the best approach. If drug resistance or drug intolerance limits your anti-HIV drug options there are other drugs that can reduce side effects like high levels of fats in the blood.

Financial reasons

If you are under financial stress, as women with HIV frequently are, it can be hard to find the co-payment for combination ARV. If this is happening to you, you are not alone, but it is an indicator that you might need some help organising your budget so that your health needs are not last on the list. For example, you may be able to pay off utility bills slowly to find the cash for your ARV.

There are also financial assistance programs for which you might be eligible, such as the Bobby Goldsmith Foundation (NSW) or the David Williams Fund (Victoria). Call your local AIDS Council, PLWHAPerson (or People) Living with HIV/AIDS. organisation or positive women’s group for information.

Treat Yourself Right