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Delay in starting medication

Jun 6, 2014

Hi Doc. I'm able to trace the time I contracted HIV (Late February or Early March this year, 2014). I'm coming into term with my status. The problem is that I'm a student and only finishing my course December next year. I intend not to reveal my status (not even my family) so I want to delay in starting treatment to beginning of 2016 as by then I will be finished with my studies. How can I help boost my immunity to avoid opportunistic Infections during this time I'm not on treatment? And is this period too long to wait before starting treatment?

Response from Dr. Young

Hello and thanks for posting.

It's difficult for me to answer questions about risk of delaying treatment without knowing more about your health, especially the state of your immune system (CD4 count). The lower the count, the greater the risk of waiting to start.

Other than antiretroviral medications, there really isn't any surefire way to prevent HIV from causing damage to your immune system and health. Indeed, there is a growing appreciation for irreversible risk of complications that may occur by waiting to start, measured by risk of one's lowest ever CD4 count, not the counts after treatment is started.

I'd like to circle back on your post and ask why you want to delay treatment-- current treatments can be remarkably well tolerated; far better than those used even just a few years ago. There should be no impact to your studies or quality of life- just a pill (or two, or three) once (or twice) daily. I have many patients who are exactly in your shoes. Medications are recommended by the distinguished US DHHS Panel for all persons living with HIV. Elsewhere the World Health Organization recommends treatment for all people with CD4 counts below 500, and for pregnant women/mothers, people with tuberculosis, or those in magnetic sexual relationships-- ie., nearly everyone too.

Meds work, they cause little interruption in your life style, and there's no reason why you need to disclose your status because of your medications or diagnosis.

A thoughtful conversation with an educated provider could help you navigate the among the seven different regimens that are recommended by current US (assuming you live here) treatment guidelines.

Hope that helps, BY



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