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Kind advise
Apr 4, 2011

Hi, My bro age of 44 , hes an HIV +ve since 1993 however due to social responsibilities he neglected and none of us were aware , hes suffering from PCP pneumonia now his CD4 counts are 48 , currently no ART started as doctor advised not to start till the time other infections are not removed from his body. I am not too sure if this is the right way as some of the doctors are saying to start ART at earliest, I wanted to know what is an average reduction of cd4 counts?..Please advise .

Response from Dr. Young

Hello and thank you for your post.

You raise a very important question, namely the optimal time to start HIV medications in someone who has an active AIDS complication, like PCP. No so long ago, conventional wisdom dictated that we'd start combination HIV medications after the completion of treatment of the opportunistic infection.

Recently, data strongly argues that medications should be started as soon as feasible- even during the treatment phase of the PCP. Such data has been replicated by several groups, in several different countries.

So, if I were your brother's doctor, I'd be planning on starting as soon as possible, provided that your brother was willing to be adherent to the medications.

I hope this helps and wish your brother well.


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