Health experts strongly advise against skipping HIV medication.
Why can’t you take a break now and then?
Well, think about an HIV medication’s job: Reducing the quantity of the virus in your bloodstream (also known as viral load) to an undetectable level.
This just means the tests cannot see the HIV in your bloodstream anymore. It does not mean the HIV is gone completely. The virus can still live in places such as the tissues of your brain,your lymph nodes, and your genital fluids in very small quantities.
As long as you stay on your meds, HIV has an extremely hard time making copies of itself. That has two excellent benefits:
- It cannot attack and kill the CD4 t-cells your body needs to fight infections.
- It’s much harder to pass the virus along to somebody else.
But as soon as you go off your meds, HIV starts replicating: attacking your CD4 cells again, making copies of itself and spreading throughout your body. This raises the possibility of the disease advancing to the AIDS stage, which you definitely don’t want.
Why You Do Not Want HIV to Start Replicating Again
Some simple math will make this point clear: Imagine for the sake of argument that you have an undetectable viral load, but there’s actually 100 copies of the virus in your body. The meds prevent the virus from hijacking your CD4 cells and making copies of themselves, but even if they could copy themselves, they would only have 100 chances to do it.
Now, imagine if you go off your meds and your viral load shoots up to 100,000. Now you’ve given HIV 100,000 opportunities to copy itself and develop a drug-resistant mutation.
Obviously, you don’t want to give HIV any chances to create drug-resistant mutations — that’s why you stay on the meds. And you definitely don’t want to give HIV 100,000 chances to create a drug-resistant strain.
The trouble with evolution is that it finds a way to help organisms stay despite any obstacles in their way. Any HIV mutation that cannot be stopped by your meds will spread like crazy until you start new meds that can fight back against it.
All this means you should try extremely hard to stay on your meds and keep taking them exactly as directed.
Why Can’t We Have "Drug Holidays" for HIV Meds?
Though your doctors don’t want you skipping your HIV medications, they understand why it happens. They know pills cost a lot of money and some have annoying side effects. And some people just have a hard time sticking with anything.
So doctors know what you’re going though. They see all kinds of patients just like you every day and they all say the same thing: It can be tough to stick with HIV meds.
Doctors and researchers have been looking high and low for a way to give HIV-positive people a break from having to take their meds every day.
But so far, they have not found a reliable way to give “drug holidays” to people living with HIV. Study after study has had the same result: Stopping HIV meds causes the virus to spread quickly in people’s bodies, attacking their CD4 cells and threatening their overall health.
When There’s No Choice but to Take You Off Your HIV Meds
There can be specific — and rare — situations where you need to go off your HIV meds temporarily. It’s up to your doctor to determine whether to do this. For instance, you might be dealing with:
- Bothersome side effects
- Drug toxicity
- Weakening effectiveness of your current HIV meds
- Preparing for surgery that forbids you from taking pills via your mouth.
- Other conditions that need to be treated before re-starting HIV meds
These are issues you have to talk over with your doctor. Never take a break without clearing it with your doctor first.
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