Questions before starting treatment
Sep 30, 2011
Dear Dr Young, I am 40 years old HIV+ guy which is thinking about starting on meds. I was diagnosed in Dic 2003, my last test was made in November 2008 showing 345 CD4 count and a VL of 1700. Since then I have no madre any test again, which i am planning to do right away because I developed some anal warts and some vary painful episodes of gingivitis. What I would like to know is the right procedure to be followed before starting meds because I do not want to make mistakes. Besides the regular CD4 and VL test is it recommended to make a resistance and drug sequensation tests? Another question I have is if I can run all this tests with you in the US? I am currently living in Bogota Colombia. Regards! Juan
Response from Dr. Young
Estimado Juan de Bogota,
Thanks for posting. Before starting medications, there are a variety of assessments that are usually done (at least here in our program in Colorado). First is a general assessment of your general health (things like mental, heart, lung, kidney, bone health)- this includes physical and laboratory examinations. We also assess your living situation for factors that could influence medical management (like housing, nutrition, home safety, disclosure, work environment). Lastly (but certainly importantly) are HIV-specific data or factors that could influence treatment decisions (such as HIV viral load, resistance tests, co-receptor tropism or HLA haplotype).
Your current lab tests, with CD4 count less than 350 would be consistent with international and US treatment recommendations to start HIV treatment. The good news is that your HIV viral load is actually quite low, so that your rate of disease progression is predicted to be slow and all medication regimens would be expected to be very effective.
In short, we'd look at the larger picture of health and lifestyle, mated to the more traditional HIV tests (CD4, viral load and drug resistance testing) to determine the best treatment options.
You could indeed have these tests done at our center in Denver, but it's a long drive from Bogota. If you're interested in more information, you're welcome to look at our website or contact me at firstname.lastname@example.org.
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