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hiv treatment
Apr 21, 2012

my wife is infected with HIV and her CD4 is 504 and her viral load is 274 . doctors reccomend that avr to start when cd4 comes below 350. cannot we start treatment for her and is atripla can be taken ?

Response from Dr. Young

Hello and thanks for posting.

At the moment and based on the labs that you report, your wife has a normal-range CD4 and very low HIV viral load. On this basis, she's unlikely to have rapid desease progression.

As for when to start medications, different doctors and different countries have differences in opinions. All national treatment guidelines recommend treatment when CD4s are below 350. Many are now moving to starting treatment earlier- here in the US, for example, the guidelines now have recommendations to treat nearly all individuals, including those with CD4s above 350 or for all persons (independent of CD4) who are over the age of 50. There are also recommendations to consider treatment for persons (perhaps like you and your wife) who have serodiscordant (one's positive, the other negative) relationships in order to decrease the risk of HIV transmission.

So for your particular circumstances, I'd suggest speaking to the care provider about your concers, knowing that with the low HIV viral load that things tend not to progress rapidly- so you have time to make measured decisions.

As for which medications, Atripla is among several recommended regimens. We tailor treatment choices based on viral, medical and lifestyle factors. Knowledge of all of one's options (and the pros and cons of each treatment) should be factored in to the decision.

I hope that helps and wish you both well, BY



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