hi just enrolled in care centre, the doc told me that my cd4 was 138 and that this is worrying that i should start HAART asap.Apart from the "alarming results" i am ok, active and about, never been down with an ilness. am scheduled for next week friday, do i start the meds straight away or check viral load first?

Hello and thanks for your post.

Yes, after a complete initial evaluation, you should be starting on HIV medications in the near future. I'm rarely an advocate that starting should be done emergently, but in your case, we'd typically start you on Bactrim (TMP-SMX) to prevent Pneumocystis pneumonia (PCP)while waiting.

Your evaluation should include both clinical, laboratory and social aspects. For example, a physical examination could reveal otherwise asymptomatic problems, lab evaluation should include (among other things) HIV viral load and drug resistance testing, liver, kidney function, screening for tuberculosis and hepatitis. Social aspects include review as to willingness and ability to adhere to medications, mental health, substance abuse.

In short, there's enough time to get the needed information and counseling about how best to adhere.

I hope you find this helpful, please write back with any questions.

BY