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probably infected but tests unconclusive doctor wants to start meds
Jul 31, 2004

One week ago I was tested for HIV. My elisa came back reactive, but my western blot was indetermanate. My CD4% was 25, CD4# 671 and VL was 55503. My docotor is recommending that I start therapy immediately and is suggesting I go on a combination of meds, combivin and sustiva. Her rational is that this will prolong the window of me serum converting and delaying the entire process and that I eventually will convert. This is all too new to me and is overwhelming to me. Is this a good thing to do and if I start meds now will I be on them for the rest of my life. Just need that second opinion. Thank You

Response from Dr. Pierone

It sounds like you are in the acute seroconversion phase of HIV infection. Since the viral load is 55,000, this confirms HIV infection despite the indeterminate Western blot test.

The strategy to begin immediate combination antiretroviral therapy for primary HIV infection is controversial. Personally, I recommend it to my patients because of the possibility that prompt treatment may favorably alter the natural history of HIV infection. However, this theory has not been subjected to a randomized and controlled trial so we don't have proof that it does work. If one does start immediate treatment, lifelong therapy is not obligated by any means. In fact, when I recommend immediate treatment, my plan is to stop after about 6 months (depending on tolerability and rapidity of viral load decline). It is also important to have viral resistance testing performed for future reference whether you go on therapy or not. Good luck!



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