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Oct 14, 2003

Hi ! Im from sweden. 45 y old and muscular/fit. I've been positive for 1 year, but I have the hiv-test in july 2003.Tested two times cd4 370/VL 96 000, cd4 510/VL 110 000. My doctor tell me that I shall not be afraid and they will start the treatment when my cd4 cell is below 200. I read in this very good site that you recomend people to start treatment if the VL is over 55 000. Please Doc ! Give me an advise, because my doctor say that if I want I can start the treatment but she doesn`t recomend me to start. In sweden they don`t look at the VL and they tell me that the VL is not so important if the CD4 cell is between 200-350. Help !!

Response from Dr. Young

Thanks for your post.

I tend to agree with your doctors-- the primary thing that I look at in deciding to start medications are symptoms and CD4 cell counts. Viral loads alone only help with regard to thinking about how fast things might progress over time-- as such, if your VL is above 55,000 or 100,000, the risk of progression increases, and therefore, the need to monitor things more closely also increases.

So in your current situation, your CD4 count is well above 350 and suggests to me that you don't need to start immediately. However, both viral loads are pretty high, so I would encourage you to make sure that you don't miss follow up appointments and get lab tests around 3-4 times a year.

Hope this is helpful. Good luck. BY

Time to Start Treatment?
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