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When Shall i Start Meds and what combination should use full for me.
Sep 22, 2013

Hi, from INDIA,I've been hiv+ for 4 months at CD4 481, my doctors suggested me to wait for treatment until my cd4 reaches 350,(there is no VL testing at ART centers so i could not enclose the same) but as per WHO recent Guidelines its good to Start treatment when cd4 reaches <=500, so please suggest me what to do in this situation? and as first line treatment here all doctors are prescribing following combination... Zidovudine (AZT) /Lamivudine (3TC) /Nevirapine (NVP) Or Stavudine (D4T) /Lamivudine (3TC) /Nevirapine (NVP) recently i came to know that we have better meds to treat HIV with small Side effects, so please suggest me what to do in this two cases....

Response from Dr. Holodniy

You are correct about what current guidelines suggest regarding when to start HIV treatment. In general, most experts now recommend starting HIV treatment when the CD4 is below 500. Previous guidelines did suggest starting when the CD4 was below 350. I don't know what the current guidelines are where you are or what constraints your doctor is under in terms of when to start. Regarding the two regimens choices, although the both have some side effects, probably best to go with the AZT regimen for now until you can get other medications besides AZT or d4T.



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