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when to start meds - inflammation
Mar 12, 2014

Hi Dr. Young, I have been positive for 9 years without treatment. CD4 averages 550 and viral load bounces between 11,000 and 60,000. I have read about the dangers of inflammation in the body due to the presence of the virus. Will starting medication reduce the damage done by inflammation? I have read articles suggesting it will and articles suggesting it won't. Any advice appreciated. Thank you.

Response from Dr. Young

Hello and thank you for asking your thought provoking question.

It's good to know that you're CD4 count has remained relatively stable for all these years. Indeed, until recently US guidelines would not recommend starting HIV treatment.

But today's guidelines recommend treatment independent of CD4 counts- part of the reason for this is the growing evidence of benefits- some of which are possibly related to chronic inflammation. Some of these include congitive health, heart and bone disease, to name a few. While the jury is out on the impact of improving inflammation- part of this due to the observation that even in some successfully suppressed patients, inflammatory markers remain elevated- with better and better medications, I'm in favor of treatment.

Whether you choose to start treatment or not, take full advantage of your health interest and ask your doctor about the full gamut of preventive medical strategies. This should help minimize your health risks and likely decrease the impact that HIV has on your health and quality of life.

Be well, BY

Atripla, tribuss and Trivenz
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