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Meds or not???
Jul 10, 2005

Hello...I have been postive for about 6 months...my past few blood results have indictaed a viral load over 100 000 but my cd4 count has continued to remain stable at around 800..do you think it is important for me to go on meds now to decrease my viral load to undetectable and keep my immune system strong or wait till it takes its toll and goes to below 350? I am remain asympotomatic. I appreciate your help.

Response from Dr. Wohl

I would not start you on HIV meds just yet given your high CD4 (despite your impressive viral load). However, I would not wait until you hit magic number 350. If I saw your CD4 really starting to decline rapidly (e.g. down more than 100 cells in a year) or you started experiencing any symptoms that could be due to HIV, I would start treatment.

There are some who take a more aggressive approach and would start treatment now. The guidelines are wish-washy here and there are really no data to look to for help. So, in addition to the style of your clinician your own feelings about therapy need to be considered. IF you are uncomfortable with your high viral load and are a take-the-bull-by-the-horn type, I can be talked into to prescribing therapy. If not, wait and watch closely.

DW



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