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Is it better to start treatment earlier
Nov 4, 2007

My mum has got HIV and she is in China. She has been taking Chinese medicines ever since she found out about it and her CD4 count had increased from 308 to 329 at first but the recent blood test only resulted 277. She was suggested to stick on the Chinese medicines untill her CD4 count fall below 200 as the doctors believe that the side effects of western medicines are seriously harmful and once you have resistance to them there is no replacement. Apparently, there are only few western medicines that are being used in China though there are a lot more available in other countries.

Is there any way we can get drugs from other countries or we can only purchase the ones that are available in China.

Should we start a regime right now and if yes what kind of information do you need us to provide to decide what kind of regime that suits her better?

Many many thanks indeed.

Response from Dr. Wohl

China is making great strides to provide HIV medications to all who are HIV+. The initial regimen in China via the China Cares Program is D4T/3TC/Nevirapine. These meds are started once the CD4 cell count drops to 200.

In the US and Europe, most start HIV medications at CD4 cell counts of around 350. If your mother can afford it, there are HIV medications that can be purchased including those included in the China Cares program. It is still important that she be under medical supervison of a doctor familiar with HIV treatment. In the bigger cities this is easier to find than in smaller cities and towns. Importing drugs from outside China is risky as any interruption of supply can lead to breaks in treatment that can risk drug resistance.

If money is not an issue, I recommend your mother ask around to determine if there are HIV specialists of good reputation (and some Western training) who can take on her case and prescribe meds that she can purchase. If there is not enough money for this, I would suggest following the China Cares guidelines and waiting until the CD4 cell meets criteria for starting medication.

DW



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