Starting Treatment or Delay a couple of weeks
Mar 30, 2013
There has been recent evidence in studies that patients who start therapy during seroconversion or within 10 or so weeks of acute seroconversion may fare better with lower viral loads and reservoir levels in the long term. I had the rash and fever the week of January 7th. My current CD4 is 481 and VL of 300,000. I am waiting on my resistance and genotype tests to come back and have an appointment on March 28th to determine how to move forward. If I start therapy around the 28th, I will be within the 10 week point of my acute serocoversion. There is a chance that I could be put on a clinical study that would start enrolling in the next couple of weeks, but I would have to go through screening including genotyping and resistance testing again and that could delay an additional 4 weeks for treatment. Is there enough evidence that I should start treatment around the 28th or waiting another 4 weeks for screening be advised for the clinical study? The study is a good one and I think would be beneficial, but I don't want to lose a window of opportunity. Thx.
Response from Dr. Young
Hello and thanks for posting.
I don't think that there is a single correct answer to your question.
Starting in a clinical trial has it's potential benefits and starting very early makes increasing sense, especially in light of recent clinical trials data on this subject.
I don't think that the current data tells us if starting at 10 weeks or 14 weeks would make any difference in the long-term prognosis; indeed, I think that either would by anyone's books be considered very early treatment.
If the study makes sense to you, then I think this is a reasonable strategy- no windows lost in my opinion.
I hope that rambling helps, BY
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