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When to start therapy considering resistance

Jul 3, 2000

Dear Dr. MH,

I am a second year med student currently doing an intern in infectious diseases, working specifically in an Pediatric HIV clinic. I see that there is some variation in terms of when to initiate HIV therapy. My question is, since there is this issue of drug resistance, when is the appropriate point to start therapy? Is it advantageous to initiate therapy early or later? what are the appropriate levels of viral load and CD4 counts? and is resistance a factor of timing of drug therapy initiation? What factors do I use to initiate drug therapy given pediatric patients and adult patients? Help ME?

Response from Dr. Holodniy

Go to This will provide you with guidelines for both adult and pediatric treatment.


Worried about Resistance if infected a long time, but never treated
Climbing VL,decreasing CD4 and resistance

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