Thanks for all the great info here. I'm looking for some clarity in differing advice from my HIV and Proctologist docs.

After finding and removing pre-cancerous anal warts (which haven't come back, thankfully) my Proc told me to get an HIV test as all of their patients with this finding use HAART to help control the HPV virus.

I tested positive and got my first labs, CD4=500, VL=14K. The HIV doc said it could be 2-3 years before I need HAART, mentioning even lower thresholds for starting than the 350 I generally see here (I shared the pre-cancer info with him as well).

Which doc should win this debate? The one who says start early and decrease chances of cancers, or the one who says wait longer before HAART?

Thanks in advance, Frank

Hello and thanks for posting.

It is quite possible that earlier treatment of HIV infection may lessen the chance of developing recurrent anal warts and anal squamous cell cancer. There are ongoing studies that are exploring this issue and these results will help better inform decisions.

If early treatment does prove lower rate of anal warts and control papillomavirus, then this will be another element to consider when deciding about therapy. Since the overall rates of anal squamous cell cancer is quite low, this should not be the primary factor driving the decision making process.