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IS IT TIME TO START?
Dec 23, 2006

Im HIV positive since 1999. In Brazil, where I live, the sense is start the Haart therapy with CD4 about 200 or less. My last results for CD4 is 483. Is important to wait more? My viral load is about 8000.

Response from Dr. Wohl

here in the US, we generally initiate therapy when the CD4 cell count is 350. This is a made up number. Data from some studies show that those who start HIV meds with a count below 200 do worse than those who are treated at higher counts. We used to feel comfortable treating when the CD4 cell count was 500. What is the number exactly between 200 and 500, right, 350.

There is increasing evidence that starting HIV treatment earlier than 200 (and maybe even above 350) is better over the long run.

Your viral laod is relatively low. This means your CD4 cell count will likely fall at a slow rate. If it was me and HIV therapy was available to me, I would start treatment at a CD4 cell count above 350.

DW



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