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Starting on ARVs
Dec 23, 2005

can one start on ARVs with a cd4 of 400?

Response from Dr. Young

Of course, patients can start HIV medications at any CD4 count-- there are many factors that influence the decision- first off, if you have symptoms related to HIV. Patients with significant HIV-related symptoms (fatigue, weight loss, night sweats or any AIDS complication) should start on medications, irrespective of CD4 count.

For asymptomatic patients whose CD4s are approaching typical guideline thresholds for starting, factoring viral load, rate of CD4 decline, CD4%, willingness (or ability) to adhere to medications are also important considerations.

I have patients who, after counseling about their options and risks of treatment, are willing and able to adhere to medications who have elected to take a more proactive stance in protecting their health by starting medications with CD4 counts in excess of 350. BY

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