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Start therapy now?
Dec 25, 2004

Hi, I am a 25 y/o gay male. I was diagnosed positive last August. Must have been a recent infection. Last February I was still negative. My CD count is 300 and my VL has exceeded 100,000. Physically and psychologically I feel very well, given the situation. Still, my doctor wants me to go on an experimental treatment. He says if I don't start taking medicines I may soon develop AIDS.I'm confused: 1) Do I really need to start treatment asap? Isn't it too early yet? I'm afraid my doctor might be pushing the therapy on me because of financial interests he may have from the development of the medicine in question. 2) What kind of treatment would you suggest? Where I live there are not many competent doctors around. That's why I really need your advice as soon as possible please. Thanx a million!

Response from Dr. Pierone

It is not imperative that you start treatment right away. It always makes sense to get multiple lab readings to better ascertain your immune status because the numbers may vary considerably. If on repeat determinations your viral load and CD4 count are in this range then treatment is appropriate, but not mandatory.

If you do decide to go on therapy it does not have to be as part of a clinical trial. Approved regimens are so good now that you should carefully consider how the study regimens compare with established treatment. Clinical research is critically important to advance our understanding of HIV and learn how to better treat patients. But this does not mean that every study that comes along is worthwhile participating in. But some studies are vitally important and altruistic people are needed to further the common good.

Potential financial conflicts of interest abound in medicine and must always be considered. If your doctor is ethically grounded he will keep your medical well-being ahead of financial considerations.



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