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CD4 ALWAYS GOOD?
Apr 8, 2008

Dear Doctor, My name is Walter, brazilian, HIV positive since 1999. I had pneumonia, sinusites diharreia, but my infectologist no decide to start the haart therapy. My last exam showed 800 CD4 36.000 viral load, but my CD4 was low like 480 and 500 and viral load about 126.000. In Brazil, the consense is start with the drugs when CD4 about 300 or 200. Is it correct in your opinion?

My best wishes, Walter

Response from Dr. Frascino

Hello Brazilian Walter,

Many factors come into play when deciding when to begin antiretroviral therapy. You can read about these in the archives. Published guidelines for when to start have been revised several times over the 26-year course of the pandemic as we learned more about HIV pathogenesis and new treatments were developed and became more widely available. Most current published guidelines suggest antiretroviral therapy be started when the CD4 count falls into the 350-cell range. With the availability of newer, novel, more potent, less toxic medications, some HIV specialists are recommending starting at even higher CD4 levels.

Good luck.

Dr. Bob


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