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recent Dx, high VL
Mar 18, 2006

I was diagnosed last month and infected within the last 2 years. Very healthy 53 yr old male. Current T cells at 650 and VL at 450,000. My Dr is 50/50 on beginning treatment. What does this VL predict? Would you recommend holding off or beginning treatment? Thanks, Doug

Response from Dr. Young

Doug,

Thanks for your post.

If I were your doctor, I wouldn't necessarily recommend treatment immediately. You've got a normal CD4 cell count and assuming that your currently asymptomatic, you've got some time to follow the trends before commiting to HAART.

You indeed have a high viral load-- forcasting a more rapid decline in CD4 counts than average-- this means that you need to be vigilant in monitoring things, rather than waiting a year for your next set of labs.

A couple or three sets of lab tests should help establish the trend in CD4 decline; if it looks fast, I wouldn't wait too long. There are numerous studies that suggest that there are advantages to starting meds before your counts drop low; I'd look at starting (in your case) when counts approach 350-400.

Current medications can be well tolerated and relatively simple to take- even with their potential limitations are better than risking needless complications or increased side effects (that often happen if you start with lower counts).

I hope this helps, good luck, BY



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