I’m thinking about stopping meds due to other health issues, what will happen?
I have been on medication for nearly 10 years and have had various side effects. I am currently taking duronivir and ratonavir but since starting I have had constant pains in my joints and particularly my fingers and feet. My doctor doesn’t think it’s because of the meds but I know it is. With my doctors agreement I am going to stop taking medication for a month to see if these symptoms stop. I am naturally nervous about stopping and so is my partner but I have to get to the bottom of this-do you foresee any problems with this?
Thanks for getting in touch.
For us to be really able to help you we’re going to need to have a detailed history of your HIV treatment, this will allow us to assess the risks of you stopping your meds. Could you please send us this through. We’ll also need to know what your age is as well as gender and if you have any other health issues.
Interruptions are really a last resort, so trying other combinations would be recommended first – for example dolutegravir + 3TC would be preferable to interrupting treatment. Have you discussed this with your doctor?
There are two other clinical problems with stopping ART.
One is that the symptoms that you have might be worsened by viral load rebound, so the question of drug side effects to DRV/r is not answered. One cause might be replace by another.
A second problem is that joint pains might take longer than a month to resolve and so the question still might not be answered if a longer time off ART is needed to see a difference.
It might be much better to first change to an easier treatment to find out whether there is a direct drug effect, without the complication of viral load rebound and at the same time get a referral for specialist advice on joint pain.
Stopping treatment is likely to lead to having a detectable viral load within a week, which could increase to tens of thousands within a few weeks. If your CD4 count was ever very low, certainly below 200 copies/mL, this would be another reason to stay on ART.
If you stop ART and your viral load rebounds they’ll also be a risk that you could transmit HIV.