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When To Start Medications
Jun 13, 2010

I was diagnosed with H.I.V. in 1994. Cd-4 Count was 1400 Viral load was minimal. I have never been on H.I.V. Meds. Currently my CD-4 Is 550, Viral Load is around 30,000. I just had a outbreak of shingles. I don't want to start meds until I have to. When should I start? Is it uncommon to be positive for 16 years and not be on meds?

Response from Dr. Holodniy

Uncommon yes, but well described. You don't indicate your age, which in addition to HIV infection, could be a factor in why you had a shingles outbreak. Sometimes, shingles, in younger HIV infected people, is marker for the loss of some immune regulation capabilities, as a result of the loss of CD4 cells and function. Although your CD4 count is still in the normal range, your viral load is in the moderate range. If you had maintained this kind of CD4 count with a minimal or undetectable viral load without meds, most experts would say you don't need HIV meds. However, given where your viral load is currently, what your CD4 count has done over these years, and the appearance of shingles, some experts would say you should start treatment now.



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