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HIV+ Where do I go from here?
Sep 11, 2003

I was recently diagnosed HIV+ and I am completely paralysed as to what to do. I do not even know my CD4 count. I started taking vitamins to boost my immune system, but have not started any HIV medication. Can you advise me what my next step should be in dealing with this disease. Also, where can I find a good treatment centre where I can get a complete evaluation of my condition, and a variety of treatment options.

Response from Dr. Pierone

It is very common to be overwhelmed with a new diagnosis of HIV infection. But don't despair because help is available and there are some clear steps that should be taken.

First you need to find a clinic or doctor that specializes in HIV management. A family doctor or internist without special interest, training, and experience in HIV medicine should not be treating HIV. The field is moving too fast and requires focus and commitment. The facility that did your HIV test usually will have a referral network. Community AIDS service organizations are another potential source of referrals. In the U.S. the American Academy of HIV Medicine has a provider list. Provider list

With regard to labs, the first test to have is CD4 cell enumeration. The higher the better these white blood cells are central to 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 other essential test is the viral load of HIV, which is the amount of HIV circulating in the bloodstream. This can range from several hundred 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).

There are many treatment options but start by finding a good clinic or doctor and begin to gather information. Let us know how things turn out. Best of luck!

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