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When to start?
Sep 21, 2005

Hello Doc. I am really concerned about my husband. He is seeing a HIV. specialist and I am not so sure that his advise is the best. He always complains that he is tired and has not felt 100% the last month. He had his labs done and his CD4 count was 260 VL. 8000. The Doctor told him that he is ok and does not need to start the drugs for at least a year. What do you think? Should we see someone else?

Response from Dr. Young

Thanks for your post.

Your husband meets the general conditions for starting treatment for HIV with a CD4 count below 350. This is particularly true for a patient who is experiencing HIV-related symptoms, like profound fatigue. It would be important to establish that there wasn't another cause of fatigue, like anemia or low testoterone levels.

That said, it's not critical that he start on medications immediately; I'd engage in a search for alternate causes of fatigue, but if none found, if he were my patient, I'd have a very low threshold to start on antiretroviral medications.

I hope this helps, BY

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