{"id":4157,"date":"2011-06-15T12:25:24","date_gmt":"2011-06-15T12:25:24","guid":{"rendered":"http:\/\/i-base.info\/qa\/?p=4157"},"modified":"2011-06-15T12:25:24","modified_gmt":"2011-06-15T12:25:24","slug":"as-i-am-missing-doses-what-can-help-or-should-i-stop","status":"publish","type":"post","link":"https:\/\/i-base.info\/qa\/4157","title":{"rendered":"As I am missing doses, what can help or should I stop?"},"content":{"rendered":"
\n

Thanks for posting a question \u00a0and allowing us to post the answer online.<\/p>\n

Your questions are all important and deal with lots of different issues. As you can see below I would need more information about your personal circumstances to provide information about some of the medical questions.<\/p>\n<\/div>\n

In general, stopping treatment is not recommended unless there is a medical reason to do this. This could however include adherence problems to reduce the risk of resistance until you are in a stronger position to restart treatment. This would only be a last resort, and would depend on your HIV history and current meds and test results.<\/p>\n

The risk of a treatment break, in terms of how quickly your might become ill, depends on how low your CD4 count went before you started treatment. It also depends on your history of HIV-related complications and how high your viral load was before treatment.<\/p>\n

Usually, viral load will rebound to the pre-treatment level within 2-4 weeks of a treatment break. Your CD4 count would also be likely to drop pretty quickly over the same time, perhaps also to your pretreatment level. For both these reasons, if your CD4 count was ever below 200, it would be better to look at how to support you improve how you take your meds.<\/p>\n

This would probably be the preferred option for most doctors, but it depends on your individual circumstances. You need to talk this through with someone without worrying about what they think. Your doctor needs to know how your life is in order to be able to help.<\/p>\n

The risk of continuing with only 75% adherence also depends on the details of your life. If you miss one dose every four days, this is different to missing one whole week every four weeks. The risks of resistance are different, so you need to talk this through.<\/p>\n

The risks are also different if your viral load is currently undetectable (in which case you have been lucky and not yet developed resistance) or if it is still detectable (in which case you could already have resistance.\u00a0In the first case, your doctor might consider switching to a protease inhibitor based combination if you are currently using an NNRTI (evafirenz or nevirapine).<\/p>\n

Because you already recognise that other issues in your life are connected to missing meds, a health advisor, counsellor or your doctor could talk through these issues with you. You need to get to the point where you recognise and overcome the pressure to miss your meds. This involves accepting that however difficult your life becomes at times, your long-term health is more important, and that you are worth getting the best chance at treatment.<\/p>\n

This is much easier to reach if you have the help and support from other people.<\/p>\n

I hope things get better. It is important that you have recognised this as an important problem, please involve your doctor in how things really are.<\/p>\n

Please let us know if we can help further, or again in the future.<\/p>\n

<\/div>\n","protected":false},"excerpt":{"rendered":"

I’ve been on meds for just over a year after finding out last year I was positive. I have been missing doses of my meds in the last month I have taken them 3\/4 times (75% of the time).<\/p>\n

I’m currently thinking off stopping the meds full stop as I have issues in my life that are going on and when I get upset and things this is when I stop taking my meds.<\/p>\n

If I stop I now I will get ill again? Some people have said to me that I will die within 6 months. Is this the case? Is there anything I could do maybe to stick with taking them?<\/p>\n

Thanks in advance<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,7,10,35],"tags":[],"class_list":["post-4157","post","type-post","status-publish","format-standard","hentry","category-adherence","category-all-topics","category-changing-treatment","category-resistance"],"_links":{"self":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/4157","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/comments?post=4157"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/4157\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/media?parent=4157"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/categories?post=4157"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/tags?post=4157"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}