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Why delay in seeking treatment?
Sep 18, 2005

I've read that one usually doesn't begin treatment until the CD4 count is below 200 or when the viral count is above 55000. I'm curious as to why it would be of interest to delay medical treatment and wait for the Cd4 count to drop. Is it that the side-effects of the medicine are so great? I've suffered diarrhea the past month which has mostly subsided and currently experience headaches but otherwise am still young and strong.

Response from Dr. Young

Thank you for your post.

All agree that with CD4 counts below 200 it's time to start HIV treatment. There are also recommendations to consider treatment when counts are between 200 and 350. I'm generally in support of these guidelines, but they are just that-- guidelines. The reason why we generally don't start treatment in patients with higher CD4 counts is becaue of the risk of side effects and the development of drug resistance, particularly in patients with suboptimal adherence to treatments. Newer treatments have addressed many of the concerns about side effects, prompting some to ask whether treatments might be better started earlier, though this remains in the realm of debate.

Symptoms of HIV, such as chronic diarrhea, are worthy of medical evaluation. If no other cause of the symptoms can be found (like colon infections and the like), then treatment of HIV might be warranted. BY



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