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STARTING EARLY
Jan 13, 2009

Dear Dr Benjamin I am age 62 and have been HIV+ since 2006. Aug 2006 CD4 = 553 Viral Load 200,000. Feb 2007 CD4 = 479 Viral Load 264,000. Sep 2007 CD4 = 695/23% Viral Load 500,000 Jan 2008 CD4 = 523/31% Viral Load 170,000 Aug 2008 CD4 = 357/27% Viral Load 171,000. Dec 2008 CD4 = 409/23% Viral Load 658,000. I am still very fit for my age, have no fat on me, am 61 Tall and weigh 95 Kilos. I have some tingling in the toes and finger tips; I take 1x300mg Neurontin capsule when needed before bed for this. My doctor has left the ball in my court to start early or not. I have decided to start medication re the high viral load, my age and now re your info where some doctors recommend starting at a CD count of 500. My doctor has recommended & prescribed Zidovudine+Lamivudine (Zilarvir 300/150) to be taken every 12 hours and 1 Stocrin Tab 600mg to be taken every 24hrs. My question to you is am I doing the right thing starting early and is this the right medication for me to start on. I would also like to thank you and all your doctors for your information and your informative website. Noel

Response from Dr. Young

Thanks for your post and words.

With your CD4 counts and age greater than 50, I'd probably recommend starting treatment. Older patients with HIV appear to be at much greater risk of disease progression than younger patients with the same CD4 count; moreover, older patients tend to have smaller CD4 count increases once treatment is started. Taken together, with a CD4 count reproducibly around 400 (or less), I'd strongly recommend starting medications.

The combination that your doctor has discussed with you is a very well tested and recommended regimen (though now in the alternative, rather than preferred list here in the US).

Best of health to you. Write back and let us know how things turn out.

BY



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