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how soon till meds?

Mar 29, 2003

i am a 35 year old male diagnosed hiv+ one year ago. my wife, with whom i ahd been having monoamous unprotected sex with for 2 years, is still negative as of 1/03.

my t-cells have ranged froma low of 420 to a high of 588. viral load from a high of 120,000 toa low of 12,000.

i am not on any meds and am beign treated by an nyc dr. whose practice is almost entirely devoted to hiv treatment.

i don't know how long i have been infected (i'm thinking since 1995)but am trying t gauge how long i may have until i need to start meds. this is relvant because since we are considereing starting a family i need an undetecable viral burden in my sperm in order to participate in a sperm washing program in boston. i am told that there is NOT a direct correlation between blodd work numbers and sperm sample numbers and I am scheduled for my first sperm/semen evaluation next week. i now this is a long question, but my wife and i don't want me on medsa any sooner than required. any input would be apprecaited.

thank you.

Response from Dr. Young

Thanks for your question.

It's difficult to predict the rate of HIV disease progression, but as you know, having a higher viral load typically means a faster rate of progression. Assuming that your current CD4 is about 500, it still will be some time before you'd have to start medications-- perhaps a year or more. What confounds this statement is the idea that starting medications will reduce your seminal viral load- indeed a reasonable idea, though I'm not sure if this would justify starting on medications if the sperm washing methods are successful. One possible approach might be to start on medications during the period of sperm harvesting-- this should, in principle reduce the likelihood of having HIV in sperm.

Let us know how things turn out, good luck. BY

HIV and Hep B/C

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