First of all...sorry for my bad english. I live in Rome, Italy, and started haart from nov. 2002 with combivir+sustiva when I had 540 CD4 and 159.000 vload. I would have liked to partecipate to vaccine trials, but nobody gave me informations about them. I would like to know if I should have waited for longer before starting haart, and if I could have been recruited for any trials in USA, coming from Italy. After 6 months of therapy my viral load is <50 an my CD4 are 950. Thanks.

Thanks for your note.

I'm not sure about the best time to start therapy because this is a very individualized question. Nevertheless, assuming that you were asymptomatic at the time of starting medications, most US-based physicians would have likely deferred on starting medications in a person with 540 CD4 cells. Your viral load was pretty high at the time, and certainly would have suggested that your rate of CD4 cell decline would be faster and might, in and of itself, be the basis for starting medications. As for clinical trials, recruitment and eligibility for trials depends on the design of the trial. Certainly if you were treatment naive, you would have qualified for any one of a number of trials, including vaccine trials.

It is clear that you've had a very nice response to therapy with undetectable viral levels and great rise in CD4 cell counts.

Good luck and keep up the adherence. BY