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Early Treatment
Sep 18, 2009

I have read that recent scientific studies promote the wisdom of early and aggressive treatment as soon as the diagnosis is made. This is contrary to current protocol of waiting through the latency period until cd4 counts reach 300-350 or OI's are diagnosed or viral loads are excessively high. What is your opinion of these studies and the posibility that once the immune system is damaged it's much harder to repair than previously thought?

Response from Dr. McGowan

Thanks for the question.

You have hit upon one of the areas of great controversy among treaters now.

If we had ttreatments that were easy to take, had no or few long term side effects and to which the virus would never become resistant than I think we would treat everyone from day 1. To the extent that thatb is not true, we have to be cautious about when we start treatment. For some people, all of the criteria are met....they are prepared for treatment, remain fully adherent and have no side effects. They will clearly do well having virus out of there systems and suppressed.

The studies on the benefits of early treatment are not conclusive, but the argument for early treatment when someone is READY and able to commit to it and can be closely monitored for side effects is getting stronger and stronger.

Best, Joe



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