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Is is time to start?
May 14, 2005

Dear doctor,

Im positive since 1999 with a diagnostic for hepatitis B too. About hepatitis, this infection became negative. Then I started to control my viral load, CD4, CD3,CD8. I had during these last six years oportunists infections, HPV, DIARREA,PNEUMONIA, ORAL CANDIDÍASE. My doctor still doesnt start de therapy with the drugs. At this moment, my viral load is about 52.930, my CD4 480, but has changed for 814. My viral load was about 10.000 and now, as I told you, has changed for 52.930. In Brazil, where I live, there is an orientation to start with the drugs just CD4 about 350 and below this number, 250, 300, etc... What your opinion about this? I feel so bad at this moment. tired, muscles pain, diarrea, oral candidíase and anal codyloma.

My best regards

Response from Dr. Pierone

The recommendations that suggest treatment initiation below 350 CD4 cells pertain to asymptomatic patients. There are some people that have HIV-related symptoms with higher CD4 counts; it sounds like this fits your situation. Since you are not asymptomatic you should push your doctor to offer you a therapy trial. Hope this helps and best of luck to you.

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