Q and A

Question

What will happen if I stop meds for other health issues?

I have been on medication for nearly 10 years and have had various side effects.

I am currently taking duronivir and ritonavir, 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?

Answer

Thanks for getting in touch.

Without a history of your HIV and treatment history it is difficult to comment in detail. This includes your lowest ever CD4 count, age, gender and any other health issues. The lower your CD4 count ever went, the higher the risk from stopping treatment. If however your CD4 count has always been high (above 350-500) it might be safer to experiment with a short supervised interruption.

Stopping treatment is really a last resort, so trying an other combinations would usually be recommended first. For example, depending on your history, using dolutegravir + 3TC might be better than just stopping treatment. Have you discussed this option 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, please be careful to use condoms. This is to protect your partner as HIV transmission risk is linked to viral load.

2 comments

  1. Roy Trevelion

    Hi Eze,

    We are not doctors at i-Base, so unfortunately we can’t answer the question about your symptoms.

    But what does your HIV doctor say? Is it possible to talk to the doctor about all your symptoms. And have they been treating you with the Malaria and Typhoid drugs. What other ARVs are you taking.

    Please let us know.

  2. Eze

    I have been on combination of Lamivudine/Tenofovir Disoproxil Fumarate since November 16th. In the mid December, I start feeling this hottness(fever) inside my body. I have taken Both Malaria and Typhoid drugs thinking they are the cause but after is still persist. Outside this hottness, am OK and fine..though slight headache at times. Meanwhile, I had no such experience immediately I started my avr drugs during the first 2 weeks..though the same drugs but 2 tablets then. What could be wrong with me? God help me am scared.

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