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viral load +
Jan 3, 2014

sir, my niece aged 27, has viral load 24300 and cd4 count is 938, her husband recently died due to the hiv aids, her girl child aged 4 years has negative hiv test result, shall my niece and her daughter start the treatment? please reply at the earliest if possible to save two lives. thanking you Er. P.A.Lalwani gujarat india

Response from Dr. Young

Hello and thank you for posting from Gujarat.

I'm sorry to hear about your family's travails. First, the daughter does not appear to have HIV, so there's no need for treatment.

Your niece clearly has HIV with an intact immune system and average viral load. Current World Health Organization treatment guidelines recommend treatment when CD4 counts are below 500 (this differs from the US where we initiate treatment irrespective of CD4 count). Many countries have yet to adopt the WHO guidelines and hold treatment until CD4 counts are below 350.

At a minimum, I'd recommend that your niece engage in medical care and get routine laboratory monitoring (at least twice annually). There are many other things other than HIV medications that can be dealt with in a proactive way-- these include getting women's care (screening for cervical health) and for example, screening for mental, cardiovascular and kidney health.

I hope this brief is helpful, but please feel free to me write back. BY

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