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Meds, Labs & Concerns
Mar 12, 2014

I was diagnosed last week - and my initial labs came back yesterday. I am a bit overwhelmed and depressed by the severity of the situation - 109 CD4 and viral load of 85,000. Other than minor thrush and fatigue - no severe symptoms. Doctor would like to wait until the genome test comes back in a few weeks to begin discussing meds. In the meantime, she has placed me on sulfamethoxazole-tmp to prevent OIs.

What do I need to do to protect myself between now and when I can get control over these numbers. How should I alter my daily routines? I am quite fearful of getting really sick.

Also, while I am obviously overwhelmed at the road ahead - I would like to educate myself on meds before the discussion with the Doctor. Can you suggest any reading that would provide me with basic knowledge of meds / benefits / side-effects. The amount of varied information on the web is confusing - and quite scary.

The doctor warned that my cd4s may never rise - which really freaked me out.

Thanks for any advice you can provide - I am quite lost.

Response from Dr. Young

Hello and thanks for posting.

Sorry to learn about your recent diagnosis. Your labs show that you do have an AIDS-defining CD4 cell count and moderately high viral load.

It's good to obtain a HIV genotype (or drug resistance test) prior to starting treatment, since about 10-15% of newly diagnosed persons in the US have evidence of significant resistance- resistance that might influence the choice of medications.

For now, it's reasonable to be taking TMP/SMX to prevent Pneumocystis pneumonia, I use this time to begin to work on adherence to the antibiotic; perhaps using alarm clocks, pill boxes or other reminder systems. This can very much make the transition to taking HIV medication pills easier.

Protecting yourself right now, IMHO doesn't require any great lengths- perhaps a little diligence in hand washing would be a good thing to do, and work on getting a balanced diet rich in fruits, grains and vegetables. If you smoke, talk to your doctor about ways to decrease and quit. And a little exercise is always a good thing. It decreases your cardiovascular and bone disease risks and actually helps ward off dementia (in one interesting study among HIV+ persons).

Remember that you (and your health risks) are no different today than they were before last week. It's very unlikely that the bottom will fall out in the week or two while you wait to start medications.

Learn about your treatment options, check out our pages here at the Forum or blogs at And of course, don't hesitate to write back.

Be well, BY

when to start meds - inflammation
Is chewing your daily med ok.

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