Rwarrior38 - Partner without meds

[Rwarrior38]

Ok thanks Jim..

I appreciate your responses. ( you must have a difficult job dealing with all the hysteria..apologies in advance )

I figure the membership I've paid for has a day or so left on it so I'll make good use of it with one more question for ya:

How long after an undetectable HIV positive person goes off their medication will their viral load start to become detectable again?

 ( I'm asking for my partner and can't seem to find that info online )

Tnx

[Jim Allen]

Hiya

Are you asking from a safer sex point of view?

Why is your partner going to stop treatment? Is he having problems with his meds?

To answer the question Viral Rebound depends on many factors, things like size of HIV reservoirs, duration of treatment, the drugs used, genetics, viral sub-type, etc etc etc however generally speaking, excluding the 1-2% SC & EC cases (Elite Controllers & Second controllers) in an adult it can be anything from a week towards a couple weeks and even lower levels viral load does cause damage to long term health outcomes, asides risking gaining resistance. There is no fixed time.

There was a small 2018 study of ART interruption with people who had full suppression of the VL in Thailand. If I recall correctly they measured every few days the VL post treatment being stopped and rebound was an average of 26 days, determined as detectable VL (Above 20 copies) I can't remember the name of the study I would have to do some digging for that

There are a few rare infant cases where its been a number of years for rebounding. 

Jim 

Fischer M., et al. 2003. HIV RNA in plasma rebounds within days during structured treatment interruptions. AIDS 17:195–199.

Oxenius A., et al. 2002. Stimulation of HIV-specific cellular immunity by structured treatment interruption fails to enhance viral control in chronic HIV infection. Proc. Natl. Acad. Sci. U. S. A. 99:13747–13752.

https://www.poz.com/article/therapeutic-hiv-vaccine-fails-stall-viral-rebound
Curiously, four (26 percent) of the participants in the placebo arm experienced sustained suppression of HIV—a viral load below 400—during the treatment interruption. This is a rate of spontaneous suppression of HIV higher than would be expected in the general population, given the small percentage of individuals with HIV who are “elite controllers” (individuals who can suppress HIV over long periods without the need for daily ARVs).

Li JZ, Etemad B, Ahmed H, Bosch RJ, Mellors JW, Kuritzkes DR, et al. The size of the expressed HIV reservoir predicts timing of viral rebound after treatment interruption. Aids. 2016;30(3):343–53. pmid:26588174

[Rwarrior38]

I'm asking because we are in Vietnam..

And we are traveling back home to Canada..but he only has enough medication ( generic Atripola  that the VIetnamese Dr prescribed ) to last until mid Feb..

 If you have been outside of Canada for more than 3 years ( we both have ) then you need to wait 3 months for your healthcare to kick in.. Which means he will have a around 3-4 weeks off of treatment before he is able to get the meditation from the Canadian Dr. ( we have run out of funds to buy anymore than that )

The Vietnamese Dr says he is already undetectable after a month...So I was just hoping you could tell me, realistically How much his viral load will increase in those 3 weeks, while we are waiting for our Canadian insurance to kick back in to effect.

I'm not sure if there is away around this, as ideally, we would like to avoid getting off treatment..but its looking like there will be a 3-4 week window where he is off meds..

Mildly concerned what this would look like for his viral load rebound, etc

[Jim Allen]

Hiya

I split your posts to this section "Someone I Care About Has HIV"

As long as the topic is not about your own HIV infection concerns and regarding supporting your partner you can post in this section and other forum members can reply to you.

Do you mean Atripla? (Generic Viraday perhaps)
https://www.poz.com/drug/atripla

I'm not sure if there is away around this, as ideally, we would like to avoid getting off treatment..but its looking like there will be a 3-4 week window where he is off meds..

If neither of you can't afford a generic than I am not sure, I'm not familiar with Canada. Perhaps one of the other forum members might have some ideas?

Whatever happens don't freak out or panic as that never helped anyone, 3 week gap is not recommended however if this is the only way than it is what it is. Have you tried reaching out to the local ASO's in Canada to see if they can offer any assistance or support?

Who knows perhaps someone will come along with a spare bottle.

Take it easy

Jim