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When to Start Treatment
Feb 12, 2010

I was recently diagnosed and my tcells are 496 and my viral load is 420,000. My doctor isn't recommending any medication until i have 350 and below tcell count. I'm surely not a doctor, but every post i seem to read including the recent CDC recommendation indicates an early begin to treatment.

I know it's not black and white, but would appreciate any recommendations on how to proceed.

Response from Dr. Young

Hello and thanks for your post.

Your doctor is behind the times (well, ok, the most recent guidelines are only about 2 months old).

Current US treatment guidelines recommend considering starting HIV treatment for most persons when CD4 counts are below 500. The previous guidelines advised treatment for CD4s below 350.

In addition, your viral load is quite high--a parameter that we often factor into when to start treatment.

Taken together, if you were my patient, I'd confirm your CD4 count, check drug resistance tests, obtain baseline assessments for heart, liver, kidney and bone (among others) health and talk to you about adherence and treatment options. I'd suggest discussing this difference and how it pertains to your case with your doctor.

I hope this helps, BY



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