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Jan 9, 2006

Dear doctor?

I'm positive since 1999 with dianostics for hepatitis B too ( cure ). My last exam shows a viral load about 21.000 and CD4 about 1.234. My doctor will repeat the exams this week and forwhile she doesn't want to start the Haart therapy. What your opinion? By the way, with my all respect, youre a handsome doctor.

All the best.

a brazilian positive

Response from Dr. Wohl

My Dear Brazilian +,

Your CD4 is quite high and although it seems strange to not treat HIV once detected available data suggest it is best to wait to start therapy until there has been a decline in CD4 cells.

The reason for this delay is that HIV therapy is not without side effects (both short and long term) and viral resistance can develop to the medications, limiting future options. If there was a potent agent that was resistant to resistance and free of major side effects we would be treating people with CD4 cell counts of 1200. But this we do not have.

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