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When should I start?
May 9, 2004

Hello, I found out I was HIV positive in April 1992 and probably infected 3 months before that. Since then, my t-cells have slowly fallen and I'm still not on meds. My last 3 counts were (based on quarterly labs) 343,21%, viral load 1350. 324, 23%, viral load 480 and my current one was 312, 21%, viral load 1480. My viral load has never gone over 2000. So my questions are, when should I start Meds? Can I wait longer and based on my numbers how long can I wait?

Thanks so much, Grand Rapids

Response from Dr. Pierone

Based on your low viral load and indolent course of infection it sounds like you could wait longer to start therapy. Below 350 CD4 cells is the level when antiretroviral therapy should be considered, but we don't have clear cut data showing benefit (quite a bit of suggestive data though). It comes down to individual choice and if you are personally leaning away from medications, no problem waiting. If you are worried about your counts and are leaning towards treatment, then there would be no argument with beginning now.

Good luck!



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