I am a 56 year old WM and I recently tested positive. I believe I've been infected for 5 months. My CD4 count is 841 and viral load is 214,000. I understand that most HIV experts recommend starting treatment when the CD4 count nears 350, however some suggest early treatment as an option for those with a high viral load. Any advice about that?

With a high viral load, typically how fast does the T-Cell count drop?

Thanks !

Thanks for your post.

I tend to use the CD4 count as the primary measure of when to start my asymptomatic patients on medications. Some doctors will use high viral loads (>100K) as a sole determinate of starting, but I'll use the high viral load as an indicator to make sure that such patients get routine lab monitoring-- every 3 months.

If the monitoring indicates a significant decreasing trend in CD4s, I'll begin discussions about starting on medications.

As for your last question, every patient is individual; it's the lab testing that is really important, rather than my gross guess. That said, in patients like you, it's not unusual to see a 100-200 cell drop per year. Even with this prediction, you might predict that it could be at least a year or two before you'd have to start on meds-- there's time to get additional lab testing to predict your individual CD4 trajectory.

Good luck, good health to you. BY