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What is a treatment interruption?

• A "treatment interruption" refers to a period of time when people with HIV/AIDS (PHAs) stop taking their anti-HIV medications. Some poeple refer to these breask as a "drug holiday".
• A "structured treatment interruption" refers to a break in treatment that is agreed upon, planned and monitored together by PHAs and their doctors.

What are the potential benefits of treatment interruptions?

There may be several reasons why people take treatment interruptions, as follows:

• Treatment fatigue:

  Taking anti-HIV medications on a long-term basis can be challenging. For some PHAs, sticking to their medication schedule every day and dealing with ongoing, unpleasant side effects over a long period of time requires a great deal of effort and can feel emotionally and physically exhausting.

  On the other hand, for some PHAs, ongoing good health may lead them to question the need for continuing to take their medications. In these cases, taking a break from their HIV treatment may seem attractive. Treatment interruptions give people a break from the burden of having to take large amounts of medications every day and from side effects that people may be experiencing from their drugs.
  

• Treatment interruptions before changing regimens:

  For some PHAs whose HIV has become resistant to the medications they are taking, their doctor may suggest a period of treatment interruption before switching them to another combination of anti-HIV medications. Stopping all medications for a few weeks or months may cause HIV to lose some of its drug resistance. In the absence of anti-HIV medications, the main strains (types) of HIV that grow back may revert to the original type (wild-type) that is less resistant to drugs, even though some drug-resistant strains may still be present. In such cases, the next combination of anti-HIV medications may have a greater chance of success in controlling the HIV.

• Stimulating the immune system:

  Treatment interruptions are being studied as a way to stimulate the body to respond to HIV more effectively. This is based on the theory that the increase in viral load that occurs when treatment is stopped may act like a vaccine to stimulate the immune system to better recognize and respond to the virus. This strategy might help some people who are newly infected with HIV; however, results from clinical trials show that it does not work well for PHAs who have been infected for a long time.

Are there any potential hazards from taking treatment interruptions?

• Stopping treatment will likely reverse the benefits you've had from anti-HIV medications.
• During a treatment interruption, the viral load will likely rise and the CD4 count will likely fall. This can increase the risk of developing AIDS-related infections, particularly if the CD4 count drops to below 200.
• Stopping and restarting medications may make it easier for the virus to develop resistance to anti-HIV drugs.
• Some PHAs who restart their treatment after stopping may find their viral load does not drop to previous low or undetectable levels.
• Soma PHAs experience flu-like sysmptoms during an increase (rebound) in their viral load.
• Some PHAs may find it harder to re-develop the habit of taking medications regularly after stopping medications for a while.

What should I do if I am interested in trying a "structured treatment interruption"?

There are still many unknowns about the risks and benefits of treatment interruptions, so stopping anti-HIV medications on your own is not recommended. It is safer to plan structured treatment interruptions with your doctor. This way, you will be able to safely monitor your symptoms, viral load and CD4 (T-cell) levels and prevent infections. Ask your doctor about different studies on treatment interruptions and find out about different treatment options that may work for you.