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Is this the correct for starting for HAART?
Dec 20, 2010

Hi. I am recently infected (less than 4 months ago). My first VL load on 10/22 was at 2199 copies (didn't do CD4). My second one on 11/01 was at 929 copies - CD4=431 at 26%. I received a HepA and flu shots on 11/22. My last blood work on 11/30 was not so good - VL was 31118 copies - CD4=335 at 20%. My doc thinks it is time for me to start medication now based on the last result. I also was traveling and had a heavy work load with time zone change from 11/12-11/21 I am sure the combination of those were not helping my immune either.

But should I start the HAART right away? Or should I run another CD4 and VL in about 2 weeks and see where I am? Is waiting for another 2-4 weeks going to make much of a difference? I want what is best for my body and I'll do whatever I have to. I'm an asian male 36, generally with good health. No history of illness whatsoever.

Response from Dr. McGowan

Thank you for your question. The increase in your viral load could certainly have been due to the recent vaccinations and may indeed settle back down, however even before that your CD4 count and % indicated that your immune system was not in normal balance. By current US Treatment Guidelines (DHHS and IAS) treatment should be offered when the CD4 counts are less tahn 500, which your's have been, despite the low viral load. If you are ready for treatment it would be appropriate to start at this point. Since your viral load is not very high it should be relatively easy and quick to get it undetectable. However, since it is on the low end, your CD4 counts may recover more slowly too. All the more reason to start sooner rather than later. There is no emergency, so when you are ready that is the best time. Discuss the options with your doctor and my best wishes to you.

Joe



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