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At what viral load level should one start meds?
Oct 10, 2013

I tested positive in August with a viral load of 1.5 million, which dropped in September to 400,000. My doctor wants to see what the viral load is in October before discussing medications, she says it should drop more. Is there a recommended viral level to start meds?

Response from Dr. Young

Hello and thanks for posting.

We generally don't use VL tests as an indicator for when to start medications, though someone with a very high viral load (both of yours qualify), the risk of disease progression while waiting to start is considerably higher (independent of CD4 count).

That said, in the US, treatment guidelines recommend that treatment be started independent of CD4 count. Elsewhere, the World Health Organization (no early start group, by any means) now recommend treatment for all HIV+ people with CD4s less than 500 who are willing to be on medications.

I hope that helps, BY

CD4 Absolute up, CD4% going down
Complera with solid or liquid food , what works best

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