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When to start treatment?
Apr 1, 2005


I was diagnosed HIV+ in the beginning of 2-2005. I must have been infected within the last 12 month. I did my first two lab tests with the following results: Lab no 1 in Feb= VL 1900, Cd4 256, 23%, Lab no 2 (came back yesterday) VL 5900, Cd4 296, 20.1%. After the first lab test my doctor said he thinks my body is doing very well in fighting the virus, because my VL is so low and he deosn't think I should start meds soon. Now after the 2nd test he would like to wait and see the trend... My question: I realize my CD4 went up a bit but what is more inportant to me is that my percentag went from 23% to 20.1%. I red that under 21% the immune syem starts having trouble working well. In your opinion, should I go on meds right away or would it be ok to wait another coupe of month? Is it possible my immune system bounces back on its own?

Thanks for your help.


Response from Dr. Young

Thanks for your post.

Your summary of your heatlh situation seems pretty accurate. Your labs fall squarely into a range where there is some uncertainty about the requirement to start on medications.

In these circumstances, provided that the patient can return for scheduled laboratory follow up, I don't insist on starting medications and will often advise getting repeat labs to assess the trend in CD4 and viral load. BY

Peter Duesberg
Chosing the right Primary Care Physician

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