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worried but need guidance
Aug 26, 2003

Hi Doctor,

I am 25 years old male medium built and pretty healthy for now. But I just tested for HIV looking at a ad of Magic Johnson and I thought "sh*t I could have HIV" so I got tested and sure enough the doc gave me a positive test confirmed with follow up tests. I am terrified of my future. What kind of side effects do the pills have " I will take them everyday" GUARENTEED. But if I take them will my viral HIV in my blood be undetectable. What is going on with my immune system now and what about when meds are started? How long are these pills good for until I am doomed? Thank you from the bottom on my heart doc. God Bless

Response from Dr. Pierone

First things first. The current thinking is that many people with HIV infection do not need to be treated right away. There are two essential tests that guide decisions regarding treatment.

The first is the viral load of HIV, which is the amount of HIV circulating in the bloodstream. This can range from several hundred (rarely undetectable at <75) to several hundred thousand. The lower the better for this test because it indicates how active the viral infection is. Those with high viral loads (over 100,000) tend to progress to AIDS more rapidly than do people with low viral loads (several thousand).

The other critical lab test is T cells or CD4 cells. The higher the better, because these reflect immune function. When someone has less than 200 CD4 cells they are classified as having AIDS. We don't know exactly when to start treatment for HIV, but the consensus is somewhere between 200 and 350 CD4 cells. This depends on many factors including symptoms and viral load.

The reason that we don't treat everyone right off the bat is because of potential side effects from the HIV medications. The main determinant of how long these medications last until resistance develops is adherence. These medications are potent, but if doses are missed, then they lose their effectiveness. For those that don't miss any doses, the chance of having undetectable virus in blood is very high and the effect should continue long-term. Let us know when you get your "numbers". Good luck!



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