I was diagnosed HIV+ two months ago. My CD4 T-cells are at

475, and the viral load is 15,000. My doctor, an oncologist and hematologist, says that it is too late for HAART, and that starting Triple Therapy could do more harm than good. He wants to wait for another 6-8 weeks, take another reading and then decide if therapy is warranted. I am afraid that the longer that I wait....the more the virus is replicating,mutating, and doing more damage to my immune system. Should I be concerned?

With the CD4 count of 475 and viral laod of 15,000, your immediate risk of developing an HIV related complication is low. You have some time to consider your treatment options. It is not too late, in fact I think some would say it is still early. Your doctor may not want to rush into therapy which is okay but you should discuss the options that are available ( for you there are many). The term HAART is imprecise- generally people use it to mean a potent combination regimen which could either be nucleosides and a NNRTI or nucleosides and a PI. The benefits of therapy at this stage are the preservation of your immune system and the excellent chance for suppressing the virus. At the current time, it looks lke treatment needs to be continued indefinetly, so the issue of determing the optimal time to start remains unresolved. Current guidelines suggest starting when the CD4 is < 500 and Viral load 10-20,000, so you are right on the borderline. Getting another reading may be a n excellent idea. In the meantime learning as much as you can about your options would be the thing to do.

Good-luck

-JC