Advertisement
The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App
Professionals >> Visit The Body PROThe Body en Espanol
Read Now: TheBodyPRO.com Covers AIDS 2014
   
Ask the Experts About

Choosing Your MedsChoosing Your Meds
           
Rollover images to visit our other forums!
Recent AnswersAsk a Question
  
  • Email Email
  • Glossary Glossary


Hit hard, Hit Fast or Hit Hard and wait
Nov 30, 2004

I tested positive about a month ago, and beleive I have been infected for close to 1 year. I dont even know my lab tests yet, but will soon be going to see a specialist in Ann Arbor, MI. Without taking lab results into consideration, can you please give me your opinion or research on what it the better way to go for starting medications. Is it, hit hard and hit fast, as in starting on meds as soon as possible, or hit hard but wait for a persons cd4 count to lower to 300? What are the pros and cons of each? I would like to know this before I go to Ann Arbor next week. Thank you

Aaron

Response from Dr. Pierone

We don't know how best to treat HIV infection.

Hitting early and hard brings the virus under control fairly easily with current medications, but the cumulative adverse events related to the medications may outweigh the benefits of suppressing viral replication. Also, if adherence is not excellent, drug resistant virus may develop and this can limit future treatment options because of cross-resistance. Another benefit of early treatment is reduction in infectivity of the person with undetectable viral load.

Waiting until the CD4 count drops is the standard of care based on all authoritative guidelines. There are disagreements in when to start and what to use as one would expect. The chance of complications from HIV is very low until the CD4 count drops below 200 so it appears to be safe to wait. Those that begin with lower counts appear to reconstitute the immune system quite well. There may be some qualitative and quantitative differences in immune function between those that start treatment early and late, but these do not seem to be clinically meaningful. Deferring therapy also eliminates the risk of developing drug resistant virus and drug toxicity.

The SMART study is well underway (but still recruiting) and compares early versus later treatment. Hopefully this trial will help us answer this crucial question.



Previous
Slow CD4 count increase
Next
symptoms related to HIV infection

  
  • Email Email
  • Glossary Glossary

 Get Email Notifications When This Forum Updates or Subscribe With RSS


 
Advertisement



Q&A TERMS OF USE

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint

Advertisement