Hi! My HIV specialist doctor wants to hold off on me starting treatment. He said I might be able to go a year without it. My cd4 is 274 & viral load is 26,000. I feel fine & have no symptoms. Is this a good idea, how fast could my cd4 count drop below 200??? Also, he said when i start there is resistance issue with atripla, so what else might he put me on & would that drug be once a day like atripla?? Im sorry 1 more question....when i do start treatment i've heard that drinking lots of water will help the drug be less toxic to your body...is this true??? Thanks!!

Thanks for your questions. I am glad you are thinking about your treatment and gathering information to stay healthy.

I would not recommend waiting to start treatment. Your CD4 is already below 350 (which is where all current guidelines recommend starting). There is growing evidence that starting sooner may be best in the long-term to rebuild your immune system, avoid toxicity of medication and avoid illness that may occcur if your CD4 dropped faster than expected.

Without knowing to which components of Atripla your virus has resistance it wouldn't be possible to make a suggestion. However, there are many drugs available that would be active against an Atripla resistant virus, and once a day (although more than 1 pill a day) options may still be very possible.

Drinking fluids, especially in the summer or hot weather, is usually a good idea to keep hydrated and maintain kidney function.

I wish you the best as you start fighting back against this virus.

Joe