Combination therapy or prophylaxsis ?
May 29, 2003
I am a 33 year woman who has been living with HIV for 12 years. In the last month I developed bacterial pneumonia while on holiday. My CD4 count was 210 and viral load 83,200. I am not currently on any treatment and now want to know whether I can delay combination therapy and just take prophylaxsis for PCP or whether it's best to treat now? Many thanks in advance
Response from Dr. Young
Thank you for your questions.
With a CD4 count of 210 and recent history of bacterial pneumonia, I'd be thinking of starting HIV therapies in the near future. Indeed, a case of "recurrent" bacterial pneumonia, irrespective of CD4 count is an AIDS-defining illness; CD4s of 210 are very close (close enough not to clinically matter) to meeting the laboratory cut-point for an AIDS diagnosis too.
So, yes, I'd recommend starting combination therapies for HIV. Additionally, I'd recommend starting Bactrim (or another drug) to prevent Pneumocystis pneumonia (PCP) and having a pneumococcal vaccination ("Pneumovax").
Good luck. BY
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