Therapy Interruption in Patients with Human Immunodeficiency Virus Infection —Two Cases Report

Abstract

Sustained use of combination antiretroviral therapy (cART) has been shown to decrease morbidity, mortality and human immunodeficiency virus transmission. However, incomplete adherence and treatment interruptions (TIs) have emerged as major challenges to the effectiveness of cART. Currently clinical physicians at home and abroad still ask about the possibility of TIs for antiretroviral drugs and the effectiveness of resumptive treatment after TIs. This report provided experience sharing of two cases in our hospital for further discussions. Both of these patients were young men diagnosed with HIV infection and their conditions were stabilized after cART with HIV viral load (VL) below 50 copies/ml (Roche Amplicor v1.5) and CD4 counts as high as 600 cells/mm3. However, the patients inquired their physician to suspend their treatment due to quality of life concern. Their VL were significantly higher (>75 000 and 57 600 copies/ml) after their treatment were stopped four months and two months, respectively. Yet they started treatment again and their VL decreased rapidly to the instrument could not be detected (less than 400 copies/ml, Abbot Real Time) by the measured value of the situation 4 months later. As "treatment as prevention (TasP)" has become the AIDS treatment guidelines, it’s extremely important to not only minimize the occurrence of TIs but also be more active in dealing with the TIs issue.