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Urgent information. Confirmed seroconversion. Starting Rx.
May 25, 2005

I have confirmed seroconversion illness and would like information about starting treatment at this stage of HIV infection. I understand that potent therapy now can lower my viral "set point" and this has been investigated by several studies. I would like to weigh up the benefits of starting now, rather than waiting (potentially for years) before starting treatment. Has there been any FIRM evidence to indicate that starting treatment during a seroconversion illness improves longer term outcomes (prognosis). I do not want to start medication unless there is CLEAR evidence that there are tangible benefits to doing so. If I do start treatment does this mean I will hyave to KEEP taking the meds? Thanks for you time - please would you respond urgently with this information. Richard

Response from Dr. Pierone

We don't yet have clear and convincing evidence that prompt treatment of primary HIV infection improves long-term prognosis. There are ongoing randomized, controlled trials that may provide a definitive answer. What we do have are a series of observational studies that suggest potential benefit. A recent study indicated that there may be long-term benefit primarily in patients that start during or within 2 weeks of seroconversion.

Most of these studies include a decision to stop therapy after some period of time to see if the early intervention accomplished anything. Most people starting therapy for primary HIV infection outside of a clinical trial would also likely be planning to stop at some point. When to stop? We don't have a definite answer but one year is a round number that many choose. Hope this helps and best of luck.

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