OPTIMA: Options in Management with Antiretrovirals

Stop anti-HIV drugs for 12 weeks, then restart with five or more anti-HIV drugs

This idea combines the effects of the drug-free period and the enlarged hitting power of Mega-ART (more than five anti-HIV drugs). It is thought that this might have the potential for substantial benefit but also a number of disadvantages.

Pros
	In small studies this approach has produced better results than other approaches.
	Harder hit to the virus when drugs are restarted.
	The HIV-drug-free period gives you and your body a rest from the side effects of anti-HIV drugs.
	The combination of many drugs may reduce the viral load.
	Gives a chance for the resistant virus to reduce.

Cons
	You may worry about not being treated during the HIV-drug-free period.
	Your CD4 count may fall and may not come back to the same level when drugs are restarted.
	Viral load is expected to rise and may take time to (or may never) fall again once drugs have been restarted.
	Increased risk of opportunistic infections and the need to take drugs to prevent them.
	Unknown how long the hard hit (the effect of the drug-free period) will last for and whether this makes a difference in the long run.
	More drugs can theoretically increase risk of side effects.
	Difficulty of taking large combinations of drugs at different times.


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