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Time to Start Treatment?
Oct 14, 2003

I was recently diagnosed as HIV+ at the end of August. I had tested HIV- in 1/03 and 6/02. I have now had 2 blood draws. The first showed my CD4s at about 275 and 19 with a viral load of 2500. The second, drawn one month later, showed my CD4s at about 300 and 18 with a viral load of 135,000. Based on this my doctor thinks I need to start treatment right away. Do you agree? Also, do you think my long-term prognosis on treatment is still excellent despite needing treatment so quickly after infection? Thank you for your advice, I appreciate your help.

Response from Dr. Young

Thanks for your post.

Between the two tests, you can see that your CD4 percentage hasn't changed much. Either way a percentage of 18 or 19 is around the time when I suggest thinking about starting therapy, more so if your viral load really is as high as the second test (it might not, and worthy of a repeat set if there's any question).

Since you've likely been recently infected, I'd suggest to you (and your doctor) to get a resistance test, to make sure that whenever and whatever meds you do start on, that they have the maximum likelihood of being potent.

Lastly, I believe (assuming that there's no resistance or that your doctor and you choose the best regimen) that your long-term prognosis is excellent, irrespective of when you ultimately need to start meds.

Good luck. BY


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