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If I Don't Feel Sick, Why Start HIV Treatment? (Editor's Pick)

Jul 15, 2015

Dr I would like to if it is safe for me not to take meds now cause my cd4 count is 390 , my GP said if I'm not getting sighns or feeling sick I can wait?all I'm using now is just selenium and centrum daily is it safe??

Response from Dr. Young

Hello and thanks for posting.

I respectfully disagree with your GP. Most national treatment guidelines around the world recommend that treatment be initiated when CD4 counts are below 500 and many nations (including US, Brazil, Argentina, Spain and France) recommend treatment irrespective of CD4 count or clinical stage. The UK has been the outlier (along with Russia)- recommending treatment with counts at 350. Proposed UK treatment guidelines will recommend treatment initiation with higher CD4 counts too.

The CD4-centric focus also ignores that many nations recommend treatment independent of CD4 count for people in sero-different (magnetic) relationships, those with viral hepatitis or TB, to name a few conditions. Treatment conclusively reduces the risk of HIV transmission to extremely low levels.

More recently large clinical trials have demonstrated reduces serious illness and death if treatment is initiated early- benefits in survival even to people with high CD4 counts.

Regarding vitamins, I generally think that they are a waste of money, and an ill-placed belief that taking them will forestall the time to need HIV medications. Only if medications are not available, and then, only really in low-income countries (presumably with poor nutrition) has selenium shown to be of benefit. No studies actually show that multivitamins are of benefit.

My 2 cents. Hope that's helpful. BY



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