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Apologies for my rant and the use of CAPS
Aug 13, 2013

Dear Dr Benjamin Young, I must apologise for the rant and the use of CAPS. I guess maybe I am a little frightened of going on treatment in the future. Albeit I feel I make a valid point, about delaying treatment when healthy! All the best. Keep up the great work Kind Regards Drew Sydney Australia

Response from Dr. Young

Hello Drew and thank you for the follow up.

No one will force you to take medical treatment that you don't want; I hope that you don't get that impression from your doctors or from our work here on the Forum.

As for when to start meds, there was a time when we waited for people to get sick before starting treatment, that's because medications themselves also carried significant risks of side effects and toxicity; also because of an under appreciation for the risks of developing drug resistance (especially with earlier meds).

The issue is that many people have no symptoms, but worsening immune function right up to the point of developing life threatening complications. We also know that irreversible risk of non-AIDS complications, like heart disease, osteoporosis and cancer may be related to one's lowest ever (and frequently asymptomatic) CD4 count.

So while your case may be the exception (ie., long-term non-progressor or very low HIV viral load), and while your apprehension about medications understandable, I wouldn't extend your experience or conclusions to the general population living with HIV.

If you have concerns about what starting HIV medications is about, I'd suggest looking over our pages and blogs here for others' experiences.

Be well, BY

Low CD4 and no symptoms
Result test for syphilis

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