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I feel like a Sitting Duck

Jun 22, 2002

I have been recently diagnosed with HIV and indeed have AIDS. My CD4 count is 116 and my viral load is well over 500,000. This frightens me immensely. I am currently taking Bactrim DS to treat PCP. But my physicians want to wait until that treatment is over before we begin the antiretroviral drugs approx. Mid July. Is this wise? I'm afraid my CD4 will plummet too fast. Am I being an alarmist? Please help me out.

Response from Dr. Young

I don't think that there is necessarily a right or wrong answer to starting or delaying (for a very short time) the starting of potent antiretroviral therapy.

In past times, we would commonly wait to initiate therapy to first complete the treatment of PCP. This approach was based on the idea that often, with the new diagnosis of AIDS, there was a lot of confusion, stress and emotional issues-- never mind the pill burden and side effects of treatment of pneumonia. This was a the more significant, given the complexity and side effect issues of earlier treatment regimens.

In the current treatment era, with a due focus on patient education and counsel about adherence, I am much more frequently initating treatment for HIV at the same time as that for PCP.

In the end, waiting a couple of weeks is probably not a crisis; this might be a very good time to try to learn as much as possible about HIV and it's treatments; figure out the best support and reminder systems to assist with adherence. All this will give you the maximum chances of an excellent response to your HAART treatments.

Good luck, stay in touch. BY

cold sweat

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