|Doctor doesn't want to start theraphy
Feb 9, 2009
Dear doctors, I was infected in Jan'08 and gave you a regular update on my status since then. When I was first infected my counts were cd4:555, vl:108000. Over the last year they both decreased gradually, April'08 cd4:410,24%, vl:89000, June'08 cd4:364, 21%, vl:76000 and Sep'08 cd4:351,19%, vl:32000. My doctor says my infection is relatively recent and the numbers are yet to reach an equilibrium, she says the decrease in my cd4 count has slowed down and the viral load is getting under control and with my next reading in a month actually cd4 may start to increase with even lower viral load. Therefore she denied putting me on theraphy and wanted to wait instead. I'm reading everywhere about the benefits of starting treatment above 350, I certainly don't want my counts to be way below 350 next time I do the test. Would you agree with my doctor that even after one year my numbers are still struggling to reach an equilibrium and my cd4 may start rising? I'm really anxious to get bad results with my next test in a month. Happy holidays.
Response from Dr. McGowan
Usually after an acute infection the CD4 and VL would change to reach an equilibrium. That may take a couple of months. Since your CD4 count is trending down despite your viral load dropping by one-third it is likely that you will need treatment sooner rather than later. What your doctor says is correct, but the timing of therapy should be balanced on when you are ready as well as the numbers. Starting treatment would be appropriate.
Good luck, Joe
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