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When is the right time to start medications
Jun 5, 2005

Good morning,

I am 29 years old and contracted the HIV virus 127 days ago. I have been trying to maintain a continuous part of my medical care. I have started to take many different Vitamins, Minerals and Trace Elements to help my immune system during the huge battle that is obviously going on inside of me. My lab values are coming back, for the most part very well. My CD4+ are 1032, CD8+ are 1050. But the concern is that my viral load is continuously climbing, from the first test of 44200 only 3 weeks fallowing my infection to now less then 100 days later my viral load has climbed to 118,000. My viral load was taken again and only fluctuated upward to now 122,000 and shows that it may not only be a blip on the screen.

My current ID specialist is recommending that I start a regiment to get my viral load under control. He has said that there is a implied benefit to starting a one year regiment during the Acute Infection Stage in reference to protecting my immune system and helping limit the damage done to it. There is obvious concern over my viral load going up and up.

My question is, should I really consider this regiment. I want to live a long life and if I can do something that can help with that goal I would gladly do it. I have to be realistic, being at the beginning and dealing with this is hard and scary and I am lost in making decisions and would appreciate any suggestions that you can offer me.


Response from Dr. Pierone

Recent studies have suggested that initiation of therapy within 2 weeks of seroconversion may translate into long-term benefit for HIV infection. For persons starting within 3 months (arbitrary cut off, I know) the data are mixed some studies say yea, others nay. Since we don't really know whether there is benefit to treat in your situation, the decision should be individualized. If you are confident that you can adhere to a regimen and are eager to begin, then there would be no argument with commencing therapy. On the other hand, watchful waiting if equally appropriate if you are hesitant to start medications.

Not a real answer to your question, but we need better studies to guide us in this area. Thanks for posting and let us know how things go.

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