Are drug holidays ever a good idea?

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Many people with HIV report that they miss occasional doses of medication, and

according to compliance research conducted at the Chelsea and Westminster

hospital in London, regular, planned interruptions in combination therapy were

Glossary

seroconversion

The transition period from infection with HIV to the detectable presence of HIV antibodies in the blood. When seroconversion occurs (usually within a few weeks of infection), the result of an HIV antibody test changes from HIV negative to HIV positive. Seroconversion may be accompanied with flu-like symptoms.

 

drug interaction

A risky combination of drugs, when drug A interferes with the functioning of drug B. Blood levels of the drug may be lowered or raised, potentially interfering with effectiveness or making side-effects worse. Also known as a drug-drug interaction.

compliance

An alternative term for ‘adherence’.

combination therapy

A therapy composed of several drugs available either as separate tablets, or as fixed-dose combination (FDC).

acute infection

The very first few weeks of infection, until the body has created antibodies against the infection. During acute HIV infection, HIV is highly infectious because the virus is multiplying at a very rapid rate. The symptoms of acute HIV infection can include fever, rash, chills, headache, fatigue, nausea, diarrhoea, sore throat, night sweats, appetite loss, mouth ulcers, swollen lymph nodes, muscle and joint aches – all of them symptoms of an acute inflammation (immune reaction).

strongly associated with use of stimulant drugs such as Ecstasy, amongst gay men

taking protease inhibitors.

But what happens when you take a longer break

from medication, either because of a drug interaction or because you simply want

a psychological break from taking pills? POZ magazine editor Sean Strub recently

took several weeks off from his demanding triple regimen. Read his disturbing

account of what happened next at

href="http://www.thebody.com/poz/columns/9_98/sos.html">http://www.thebody.com/poz/columns/9_98/sos.html



The

consequences of a drug holiday may be equally serious in people who begin

treatment prior to seroconversion, according to a recent report in Annals of

Internal Medicine. A man in Los Angeles began anti-retroviral therapy five days

into an acute seroconversion illness, but stopped his AZT/3TC/ritonavir regimen

because of side effects after six months. Within a month he had developed an

illness indistinguishable from his original seroconversion illness, and his

viral load rebounded after nearly five months below the limit of detection. Read

the full report at

href="http://www.acponline.org/journals/annals/15may98/acutehiv.htm">http://www.acponline.org/journals/annals/15may/acutehiv.htm