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Starting meds with a CD4 count above 500.

Sep 17, 2006

The 14th of August I decided to start HIV treatment. My Dr. agreed and put me on Sustiva and Truvada. My counts were 503/25% Cd4 and V.L.:80.000. I am not suffering any side effects so I am very happy with my decision but I dont know if starting so early can increase the risk of toxicity. I dont know if my decision was wise, but I was not going to leave the Drs office without my prescriptions. HIV scares me much more than the meds. What do you think?

Response from Dr. Holodniy

You will probably not get 10 HIV experts to agree on when the optimal time is to start HIV treatment. There are those who say it is important to preserve the immune system and so starting earlier is a good thing and far outweighs any potential for toxicity. Then there are those who say, there is no immediate risk for immune system problems and therefore it is better to wait until there is demonstrated damage to the immune system before starting. This also potentially delays and possibility of toxicity from meds. Some might criticize your decision for starting early. But I think it is very much an individual decision. The regimen you are starting now comes as one pill (atripla) given once a day and is very well tolerated with minimal if any side effects or long term toxicity.

spike in VL
CD4+ & Toxo

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