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I was recently diagnosed with hiv. My cd4 count is about 400 and viral load is 30000 with no mutations. Would I be better off to start taking ART now or should I wait? Also, I am having what I am being told is anxiety, which started before I was diagnosed. I am taking Lexapro 10mg, Bactrim, restoril and now buspar. If I were to start ART and lower my vl and raise my CD4, is there a chance this would resolve itself enough for me to get off these other meds?
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Response from Dr. Wohl
Your CD4 cell count of 400 puts you on the cusp of threshold for starting HIV meds. For most people I see in clinic with a count of 400 and who are mentally prepared to start meds, I recommend treatment.
Why you are on Bactrim is unclear. You are not at risk for PCP pneumonia, which this antibiotic protects against, as your CD4 cell count is well above 200. Your viral load going down may make you feel relieved but that alone may be insufficient to reduce your need of the depression and anxiety medications.
Talk with your doc and ask why your on Bactrim and share your eagerness or lack of it for starting HIV treatment so you can make a decision together about what is best.
DW
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