Dear Dr. Pierone, I am an adult gay male with seven months sobriety, recovering from addiction to crystal meth. Througout my six years of active addiction my T cell count was anywhere from 800 to 450. Now with seven months clean which includes eating 3 meals a day along with 8 hrs sleep a night, my T cell count is at 250! My friends and doctor tell me not to worry and my doctor wants me to get use to sobriety before starting me on meds. My viral load is has stayed consistently at 29,000. I guess my fast living has caught up with me because even though I have fewer T-cells, I do not plan to abuse my body the way I have in the past. Do you agree on delay meds for a while?

Yes, it makes sense to delay therapy and see if this drop in CD4 count is an aberration or a verifiable trend. If on repeat testing the CD4 count is confirmed to be in this range, then it would be reasonable to begin therapy. Congratulations on your sobriety and best of luck!