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I'm ready to start meds. My MD isn't...
Jan 19, 2008

Hello, and thanks so much for your time and the help you offer all of us.

I'm a 32 year old who was diagnosed in July 2007, with initial CD4 count of 348 and viral load 10,000. I've been mostly asymptomatic except for a few URI's and some mild fatigue. My follow up labs in Dec. 2007 show CD4 309 and viral load 15,500. I didn't get the ratio.

I'm more inclined to go ahead and get started on meds, however my ID wants to wait until April and get more labs. I've still not had a genotype drawn yet either.

I strongly believe that I'm ready to start meds and able to take them appropiately. Is it worth being more forceful with my ID on starting meds, or is it okay to wait 4 months?

Thanks you so much.

Response from Dr. Young

Thanks for your post.

I'm not exactly sure why your doctor would be reluctant to start medications. Both of your lab tests show CD4s that meet general criteria for staring HIV medications.

Nevertheless, it would be definitely important (and also in keeping with treatment guidelines) to obtain HIV drug resistance testing before choosing medications.

It is not likely a huge issue to wait a few additional months to start- this is certainly a good time to make sure that all other factors (like mental health, housing, drug use, etc) are in good order before embarking on the really important issue of HAART adherence.

I'd also ask your doctor to explain the basis of the wait- maybe there are other competing medical issues, maybe it's to wait for the resistance test. If the later is true and you're willing to start medications, it shouldn't take more than 2 weeks to get the results.

I hope this helps and wish you good health, BY



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