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i was just diagnosed
Jan 11, 2005

I'm a 44 yr/old man and was just diagnosed HIV+(12/15/04) Iwas told today that my CD4+ is 214 and viral load is 29, doctor gave me sustiva and combivir. I have friends who are HIV+ positive, and say I should wait, from what I've read I shouldn't. How do you figure out the time line from when I was infected..5,000 copies per year? And what is the real life expectation, or until I get AIDS..I'm sick of Pollyanna responses to CD4, let's face it I have AIDS

Response from Dr. Young

Thanks for your questions.

I'm very sorry to hear about your recent diagnosis. I can't speak to pollyanna, but would comment that you've likely been HIV infected for some period of time, probably years. This is because on average, it takes 5- to 8 years to progress from initial infection to having a CD4 count that is about 200. Beyond this, it's really impossible to have a lot of certainty as to the time from initial infection, as much as we'd all like to have this ability. These time lines are only a very crude estimate, so take it for what it's worth.

Should a person with a CD4 count of 200 start on treatment? I'd have to say yes, though I'd probably would like to see a confirmatory lab value before making this a certain thing. All current treatment guidelines (both from within and without the US) recommend starting treatment with this level of CD4s. Combivir and Sustiva is one of the most prescribed and highly recommended regimens, with a very low pill burden (taken twice daily) and very good long-term study data.

Lastly, let's be clear on one point about AIDS-- assumming that you're otherwise asymptomatic and have a CD4 count that is greater than 200, you do not meet standard criteria for "AIDS". You're close, and this is another reason to consider starting treatment, but don't have AIDS, you "merely" have HIV infection and that's serious enough.

Good luck, thanks for reading. BY

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