Thinking of Taking a Holiday? Think Again

[Robert]

This article came out today in the New England Journal of Medicine.

It sort of negates the idea of starting meds early so later on you can take a holiday.  Apparently ti doesn't work that way.

HERE"S THE ARTICLE as reported in today's (Nov. 30) SF Chronicle.

robert

[Oceanbeach]

Hi Robert,

I just received this article this morning by email.  One of our local physicians was discussing this a few months ago at the Planning Counsil meeting.  While another member of these Forums questioned the concept of "taking a vacation" recently, I could not find the notes from that discussion.  Thank you ever so for posting this.  Have the best day
Michael

[anniebc]

hi Robert

Thanks for the info, I started my drug holiday 3 days ago and have just recieved my new results

Last CD4's were 1040..now at 750..a drop of 490..since July

VL..still undetectable

So I'm assuming that my numbers will see me ok and keep me healthy enough until I can go back on my treatment after we have determined wether or not it's the meds are causing my liver problems.

Hope all is well with you and are heading for a good weekend.

Hugs
Jan

[Blixer]

I think those results were from the SMART study which was the largest treatment interruption study to date.  It was supposed to last 9 years but was interrupted after something like 16 months becuase of the results.  The SMART study stopped treatment when the CD4 was 350 to 400 and restarted when it dropped to 250.

There is another, much smaller study, called the STACCATO trial.  It had a restart cutoff much higher--350.  And there seems to be some positive results from that study.  So maybe it isn't an "all or nothing".  Maybe it is somewhat dependent on where you are when you stop and where you are when you restart.  Here is a quotation from an article on Aidsmeds about the SMART study.

"It is important to note, however, that other studies evaluating treatment interruptions of this nature have reported more encouraging results. In the August 5 edition of The Lancet, for example, the STACCATO trial found that treatment interruptions reduced the risk of side effects compared to those on continuous treatment. The study, enrolling 430 HIV-positive patients, used a CD4 count of 350 to signal the restart of treatment, which differs significantly from SMART’s 250 CD4 cell count cutoff. "

[skeebo1969]

   Thanks Robert for the article.  Very interesting indeed.  I printed and put it away for safe keeping...  just in case a doctor ever tells me something different.

  Thomas

[Life]

Jan,  please be careful honey... 

[megasept]

Hi. I laughed and when I read Jan's post regarding her 3 day drug holiday (not laughing at the reason of course), thought it was a typo. My STI has been six years. My VL is growing now, and my CD4 has been fairly steady, recently climbing back slightly to 500. By the way my, STI was recommended by my MD, and it took me four days to decide to give it a try. I am not fickle.

Having shared this info, I have been wondering whether I am better off or would have been better off either resuming now (new drugs) or having resumed much earlier.

I am totally open-minded on the STI issue. Of course I want my STI to be the "right treatment." Dr. Fauci has been wrong before. Dr. Currier from UCLA who said the results were "definitive" does have my respect. I would like to read everything I can on the issue, not just reports on the NEJM article. If any of you have any such links, kindly send them my way or post them here. Thanks, Megaasept

[Eldon]

Hey Robert,

That is interesting. Perhaps there could be a different way to approach this.


Make the BEST of each Day!