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Infected < 1 year, start therapy now?
Jun 7, 2003

I was diagnosed with HIV in 12/02, and believe I was infected in 7/02. My VL/CD4 in 12/02 were 3,300/754, then in 3/03 were 34,000/725 and in 5/03 were 74,000/695.

I'm aware of the 50,000VL/300CD4 threshold, but in my case while the VL is increasing rather quickly, the CD4 is pretty stable, and actually the CD4 percentages are better now than when first tested.

Should I start drug therapy now to minimize the VL before it has a change to continue its climb, or just wait and see if it levels off or decreases on its own (which seems unlikely), or wait until my CD4 drops closer to the 300 level?

I haven't seen any effects from the virus, I'm 37 with a very healthy and active lifestyle.

Thanks for your help.

Response from Dr. Young

If it has been over 4-6 months since known initial infection, I would defer on starting therapy-- you are correct in your want to monitor your viral load and CD4 count closely, though.

The fact that your CD4 percentage is stable (or increasing) and that your asymptomatic are in strong favor of defered starting of antiretroviral medications. However, a rising- or very high viral load might presage the need to start meds sooner that average-- this is why following your lab work will be so important. BY


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