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On skipping taking ARVs

A Filipino PLHIV asks about the repercussions of missing taking his ARVs, and Dr. Jose Narciso Melchor Sescon answers. It is imperative to know that once HIV clients start on ARV treatment, they need to understand that this is a lifelong engagement, he says.

Dr. Jose Narciso Melchor Sescon – president of the AIDS Society of the Philippines and current Chief of Clinics of Sta. Ana Hospital – answers all your HIV-related inquiries. For all your questions, email or

Dear Doc,

Because of the shortage of ARV supplies where I am in Mindanao, I have missed taking my ARV for one week now. My hub continues to say that there is nothing they can do for me, as we all wait for supplies to arrive. How will this non-taking of ARV affect my body?

Mr. Missed Meds

It is imperative to know that once HIV clients start antiretroviral (ARVs) treatment, the next step is to commit to this as a lifelong engagement.


Yes, lifelong ARV treatment until the newer evidence will show that newer medications and/or HIV vaccine that offer time flexibilities and hopefully, HIV cure. For now, up to the date of write-up, it is encouraged that ARV prescriptions are taken with good compliance according to doctor’s instructions.


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Now about ARV supply – this is another issue/concern being raised, that is, HIV accessibility and sustainability.


Basic knowledge for all: For any medication to gain maximum effects, all meds should be taken with good compliance. For HIV, good compliance would mean good immune response as determined by laboratory parameters such as CD4 count and viral load suppression to undetectable levels.


Now, if there will be “missed” ARV intake, what is expected is that the viral suppression achieved may go on rebound and thereby efficacy of HIV medication will be compromised and this will have an effect on future ARV therapies to be used. There are cases wherein drug resistances happen and this lad to treatment failures. For this, the doctor will have to choose more “potent” ARV combinations – we refer to this as “salvage” treatment/therapy to suppress HIV replication back to undetectable levels. Worth mentioning is how these could pose strain to human organs such as the liver and kidneys.


In summary, efficacy of ARV treatment is dependent on patient’s compliance, so avoid missing pills. Health systems strengthening in terms of ARV access and to address ARV sustainability has to be addressed by concerned government agencies, and it has to be considered as a priority concern.

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