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starting treatment
Oct 12, 2002

If one finds out that he is acutely hiv infected within the past 3 months, what is your opinion on whether to start treatment at this stage vs. waiting until numbers deteriorate?

Response from Dr. Wohl

When people are still in the stages of acute infection and have not fully seroconverted, meaning the ELISA and Western blot tests are not both positive for HIV, there is early evidence that HIV therapy can be beneficial in keeping the viral load low even after therapy is stopped later on. The idea is that early treatment during acute infection might help preserve the body's specific immune responses to HIV.

In cases where the individual has already HIV seroconverted most clinicians would probably look at the CD4 count and HIV viral load trends before deciding to initiate therapy.

There are gray areas between acute infection and established infection such as when the HIV antibody tests give borderline results. In these situations treatment is considered on an individual basis. If at all possible, treatment of acute or early HIV infection should be done in a research setting as part of a clinical trial. DW



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