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Meds or no Meds
Jul 20, 2006

I am recently diagnosed HIV+ my numbers are still good, but the big question is Meds or not? why the controversy with Doctors I have one that says go meds now and keep your numbers high and viral load low and one that says stay off meds and keep monitoring your numbers. I am very confused part me says go on meds and keep the viral load very low so its not running crazy in my system, the one Dr. say's the meds today are not as toxic as before so early prevention is better. Can you shed any light to the above theory's and does anyone have any supporting evidence that holding out on meds is better?

Thanks Again you have been a great help since my recent Diagnosis


Response from Dr. Pierone

Hello and thanks for posting.

I really wish that I could provide a definitive answer, but we simply do not have the evidence to let us know which theory is correct.

The conventional wisdom and guidelines suggest deferring therapy until the CD4 count drops below 350 cells. The risk of such an approach is quite low since it is rare to have a serious opportunistic infection when the CD4 count is above 350. But it is true that HAART today is less toxic and more convenient. As a result some experts are suggesting we consider raising the CD4 count threshold for treatment. One interesting side point which is not terribly scientific but I think is worth mentioning. If one polls HIV treating doctors what they would do personally if they had HIV infection, most would start therapy much earlier than the guidelines recommend. But absent hard data we rely on expert opinion and consensus guidelines.

Here is the link if you want to read the DHHS guidelines.

Best of luck!

Suggestion & Lipodystrophy
Atripla and Treatment Failure

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