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In thailand
Mar 6, 2006

I contracted HIV in thailand, I was tested in Nov 2005 HIV+, I am a 25 yr old US citizen working in Asia. I recently got kicked out of singapore due to my infection. my test are Nov.CD4 380 VL 33,000 Jan CD4 431 VL 71,000 March CD4 420 VL 110,000 now the doctor in singapore wants to start treatment the doc in thailand does not. I will not be going to the USA anytime soon. What do you think i should do? Thank you for your time

Response from Dr. Wohl

You are on the cusp. Most docs in the West like to start HIV meds when the CD4 cell count hits around 350 and even earlier when teh viral load is high (as yours tends to be). Converging data suggest benefits of starting at even higher CD4 counts.

(Note, in Thailand and most developing countries, the threshold for HIV treatment initiation is 200 - reflecting the economic and supply issues of therapy.)

So, you are close to to this magical 350 but there is no emergency. If this is an opportune time to start meds, do so. If you prefer to wait a bit, you can. I would just make sure to keep tabs on your CD4 every 3 months or so. Any further decline should trigger treatment.

DW



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