Hi Dr l live in brisbane Australia and recently become hiv positive in january 08 after a trip to asia, l am hetrosexuel male 35 years, l found out in may and my first test was %25 and cd4 count 435 my second test was viral load 14,000 and cd4 count 380 and %25 my last test was %21 and cd4 count 460 and viral load 20,000... l dont smoke and train at a gym and have always eaten well but binge drink now and then, is it better if l start now well l am strong or wait till the cd4 starts to drop ??? what type of side effects will l expect if l start treatment on kivexa and nevirapine once daily in the morning, that is what my doc said would work best for me once l am ready ??? will l get the sunken cheeks look or hair loss with these two drugs ??? my greatest fears, also what damage would hiv be doing to me right now at around 20,000 viral load untreated ??? thank you for your expert opinion

Please see my answer to the (?your) similar question 'not on meds but best first time meds'. Current recommendations on tretment starting would be CD4 <350 (on 2 consecutive occasions) or symptoms suggestive of HIV. Specifically, nevirapine should be avoided in men with CD4 >400. The viral load level is not used in treatment edcisions to any great degree but your viral load simply says you need treatment at some point, so you have a good opportunity the plan you therapy Best Wishes Dr Moyle