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Should I start treatment with my partner?
Apr 18, 2012

I'm a 31 year old male and he is 40. We've both tested positive recently. My CD4 count is 564 (VL 14228) and his CD4 is 380. The doctor has recommended that when he starts treatment, I too should start as it is safer to do so in partnerships. Do you agree with this recommendation? In South Africa, where we are, they recommend starting treatment at a CD4 count of 350 in terms of the law.

Response from Dr. Young

Hi and thanks for posting from South Africa.

You raise an interesting question- one without a definite answer. First off, it would probably be ok for you to wait to start medications. On the other hand, treatment guidelines here in the US would probably support starting treatment in many people with CD4 counts higher than 500. There are data that suggest that starting with higher CD4s results in fewer complications and lower risks for side effects.

One of the reasons to start at the same time as your partner has to do with the ability of you and your partner to help each other with adherence and any (rare) possibility of side effects of your meds.

So, if you were my patient here in the US and willing to start on medications, I too would recommend starting.

I hope that's helpful, BY

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