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Should I or Should I Not?
Nov 26, 2004

I am considering starting meds base on information I have read and from talking to people who have been positive for years. My question is, If I have a cd4 520, which is steadly droping and my viral load is 137,000.Do you think that starting meds is too soon? I am 24 and I was diagnose in Dec. 2003. Your help is greatly appreciated.

Response from Dr. Young

Thanks for your question.

It's difficult for me to give you a absolute answer as to when to start medications-- however, if you're feeling well and have a CD4 count of 520, you don't have an immediate need to start.

You're viral load is pretty high, at over 100,000 and this forecasts that you are at risk of having a more rapid CD4 cell decline over time, but the actual rate of decline is something that is best determined by repeated laboratory testing.

In a general sense, I don't usually recommend starting treatment for HIV in asymptomatic persons until their CD4 counts drop to levels below 400 or even lower. The key thing is to continue to get clinical and lab monitoring on a regular basis-- develop a discussion about the optimal time to start medications with your doctor-- this is probably your best asset in making the best possible decisions for your particular situation.

Good luck, thanks for reading. BY



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