Question
Will stopping meds reduce fatigue?
17 November 2009. Related: All topics, CD4 and viral load, Changing treatment, Living with HIV long-term, Side effects, Stopping treatment.
Hello
I am 47 year old gay man & have been on meds for 5 years now. I remain undetectable with an average CD4 of 500, which I think is low.
I have yet to find a consultant whom I can trust/relate to. My first one put me on Combivir even though I was worried about facial wasting, within 4 months it was apparent, I am on to my third now.
I constantly complain of fatigue. I am told that it is part of the condition & that I have to live with it, but this is wearing me down. I have also been diagnosed with depression by my GP whom whilst are very nice have admitted that have no experience of dealing with an HIV patient.
I have constantly over the years adhered to my meds, I dont do rec drugs, I don’t smoke & I practice safe sex.
Finally, my questions are:
1) If I stop taking the meds will I initially feel better because I don’t have these toxic drugs pumping round my body ? and
2) Also, how long will it be before I start to develop AIDS? Obviously you cannot be specific, but an average would help.
Answer
Hi
Thanks for your question and for letting us post the answer online.
The two important pieces of information that would help answer your question include how long you have been HIV-positive and how low your CD4 count dropped before starting treatment. The longer you have been HIV-positive and the lower your lowest ever CD4 count, are both likely to increase the risks from stopping treatment.
You also don’t say which drugs are in your current combination, which is also important, and where you are treated (ie is this at a large experienced centre?).
Although you feel that the HIV drugs are causing your fatigue, this may not be the case, so it is important that other possible causes are looked at.
If you discontinue treatment, you are probably more likely to feel more ill in the short-term, because your viral load is likely to rebound to detectable levels within a week and may be back to your pre-treatment levels within a few weeks. The high levels of viral load are more likely to make you feel worse than medication, and definitely increase your risk of more serious illnesses.
Your CD4 count is also likely to return to pre-treatment levels within a couple of months, and in the SMART study, even 18 months after restarting treatment, people who had taken a treatment break had a CD4 count that was 150 cells lower than when they first stopped treatment. ie – even if you did feel better for a short while, this is likely to have a long term negative impact on your CD4 count.
Your current CD4 count is actually very good – 500 is considered ‘normal’,
It is important to find out what is causing your nausea though, and to ask for a referral for support with your depression. HIV experience, although preferable, isn’t always the most important factor.
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