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Time for treatment?
Mar 23, 2004

Hello, I was diagnosed with HIV two years ago. At my latest control, my CD4 have risen from 400 to 701; however, my viral load has gone up from 25.000 to 450.000 copies. My doctor thinks that only I can decide whether to start treatment or not (combivir + stocrin). Otherwise I don't have any major health problem related to the infection. Please, advise. Thank you.

Response from Dr. Young

Thanks for your question.

In general, I use the CD4 count as the major factor in deciding when to start, and the viral load as a measure to predict how quickly the CD4 count might decline-- using this rough guide, a CD4 count of 700 probably does not indicate that you must start treatment right now.

That said, the rise in viral load is a predictor of impending decline, and suggests that your counts could drop in the near term future (assuming that it was drawn when you weren't sick or had a recent vaccination). This suggests that it'd be a good idea to not miss your next lab assessment or office appointment.

Hope this helps, thanks for reading. BY



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