Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date. I've been positive for 18 years, and am up to a 5-way cocktail because of resistence: Viread, AZT, 3tc, TMC125 (trial), and Kaletra. I've never been sick and tolerate the 22 pills a day with no problem. Except, I wonder about my liver processing pills for nearly 15 years. Couldn't I stop completely, monitor my T-cells and viral load, and only start again when they get high/low? Since I'm so resistent already, is there really any danger in stopping?
Treatment interuption strategies have been under study for a few years now, and in "experienced" patients such as yourself few benefits have been seen. If you are tolerating the drugs, I would not be too worried about the metabolic demands placed on your liver; it's apparently doing the job well, and I know of no reason why this should change. Nobody knows what the long-term toxicities of these drugs will prove to be, and it is a valid concern, but we all know what the long-term consequences of uncontrolled HIV replication are!
Most individuals who stop medications will, over a course of weeks to months, have a sharp increase in viral load, and decline in T cells back to their pre-treatment levels. There are some individuals who will go long periods of time without dangerous changes, but these are a minority, and it isn't possible to predict who will have a good response.
While emergence of resistance off treatment is not a major concern, many do feel that a low viral load, even if not "undetectable" is better for control of HIV disease than being off of medications, entirely.
My own view is that it would be better to keep on doing what you're doing, as it seems to be tolerated well and working ok. I don't think it would be a catastrophe to stop, but I don't think it would be very beneficial, either.
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