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Newly diagnosed with HIV
Dec 10, 2008

I really appreciate your rapid response. Unfortunately, the HIV diagnosis is confirmed, apparently after 3 blood tests. The CD4 is also more or less at 94 although it has shown slight variations over the 3 tests. I am being put on "Truvada" plus something else to be determined in the next week or so. I am a little disorientated at the moment especially since I have been told that don't have any "real symptoms" yet. I personally think that this must date back to a number of years but how many ? That is what I need to know and try to act accordingly. Thank you again - This is not easy to say the least and I am very confused. Kind Regards

Response from Dr. Young

Thanks for your follow up.

Sorry to hear that the tests were confirmed.

Moving onward, I'd again reaffirm that you should be on HIV treatments- Truvada is a very reasonable component of first-line therapy; preferred by the current US Department of Health and Human Services treatment guidelines.

Be sure that you receive a third medication in association with the Truvada. The difficulty is that without a measurable viral load, HIV drug resistance testing cannot be performed. Since non-nuke resistance is the most common (about 10% of US patients), the use of efavirenz (or the triple combination Atripla) is less attractive as an option. Rather, I'd be looking at starting a ritonavir-boosted protease inhibitor-based regimen. In our practice, many patients elect to start this way, usually with either fosamprenavir (Lexiva) or atazanavir (Reyataz). Other recommended PIs include lopinavir (Kaletra) or darunavir (Prezista).

As for how long you've been infected, it's really difficult to be sure. With the undetectable viral load, one would have predicted that you had very slow CD4 count (or disease) progession. Hence, I'd estimate that you've likely had HIV for many years, perhaps over 10.

Please, please, if you remain confused, feel free to write back.

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