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Dec 14, 2013

am frustrated with my care provider my cd4 is4oo down from 687 but she is not starting me on arvs claiming that it can still go up. my worry is that she says so because the is no meds to carter for every one yet ican get some online from india.should i tell her to prescribe some for me?

Response from Dr. Young

Hello and thanks for posting.

While CD4 count tests do fluctuate, if confirmed your level meets criteria (in most countries) to start antiretroviral medications.

Indeed, the World Health Organization's consolidated HIV treatment guidelines now recommends treatment for all people with CD4 counts below 500. From the guidelines: ART should be initiated in all individuals with HIV with CD4 count ≤ 500 cells/mm3 regardless of WHO clinical stage.

Here in the US, things are simple. Treatment is recommended by the US Department of Health and Human Services Panel for all people living with HIV who are willing to take and be adherent to medications.

Perhaps a confirmatory CD4 count test might give extra ammunition in a discussion about when you should start treatment.

Be well, BY

Hiv and PEP
changing dose

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