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Newly tested HIV +
Aug 15, 2006

Dear Sir,

I have just tested HIV+ with a CD4 count of 269. I have a skin condition which lead me to take this test. My doctor suggests not immediately beginning me on ARVs. Please advise on what steps I should take to increase my CD4 count and immune system. Thank You

Response from Dr. Young

Thanks for your post.

There's no CD4 count shoe that fits all with regard to when to start. There is agreement across the globe that once your counts are below 200, it's time, but with higher counts there's variabiity in recommendation.

I generally believe that medications should be started much sooner than when counts drop to 200 and usually discuss starting treatment in patients with counts between 350 and 400. Short of HIV medictions, there's little other than good diet that will improve your CD4s.

In the meanwhile, this is a good time to invest efforts in preventive medical strategies- vaccinations for hepatitis, pneumonia, tetanus; getting your mental health in order. Make sure that your doctor orders HIV drug resistance testing; current guidelines strongly recommend this, since ~10% of newly infected patients have evidence of some drug resistance.

Good luck, BY



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