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
   
Ask the Experts About

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


New standard for starting HAART?
Jan 28, 2005

I have consistently read in this Forum that the standard for starting HAART is with CD4 count somewhere between 200 and 350. I have also generally heard that viral load is not much of an indicator of when to start HAART, especially compared to CD4 count. I recently heard that new thinking is that HAART should be started when CD4 falls below 500. What are your thoughts on this? I'd obviously like to delay starting meds as long as possible, but certainly not at the cost of doing permanent damage to my immune system. Also, is there some level at which viral load needs to be factored into the decision, even when CD4 count is high? Thanks, as always, for your sage and reassuring advice!

Response from Dr. Pierone

The formal guidelines have not changed at this point and probably won't for some time. Of course the guidelines are written mainly by older white male academic physicians that don't actually treat very many HIV-infected patients (because they are busy doing research and writing guidelines).

But the new thinking by some early adopter type HIV thought leaders is to consider starting antiretroviral therapy sooner. It was the cumulative toxicity of first generation antiretroviral cocktails that spearheaded the shift towards deferred treatment. So it is logical that one of the drivers back towards early treatment is the emerging consensus that newer antiretroviral regimens are safer and easier to take. But I don't think that delaying therapy will lead to permanent damage to the immune system.

The viral load is important in a general sense in that a higher viral load would shift the balance towards early treatment. There is a rough correlation with average viral load and rate of CD4 count decline, so it does deserve consideration.

Thanks for posting and stay tuned.



Previous
Early versus Late treatment
Next
2 doctors 2 opinions on proper therapy

  
  • 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