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HIV positive
May 7, 2017

Hello Dr, I have been diagnosed HIV pos a week ago, and myCd4 results came today. My VL is 250copies/mm3, and CD75, the Consultant advice I should start treatment as soon as possible, He said I should start Tenofovir, is this the right medication to start with? Thank you. Alech, Nigeria

Response from Dr. Young

Hello and thank you for posting from Nigeria.

Nigeria is often forgotten in the global view of the HIV epidemic; it shouldn't be. Nigeria is second only to South Africa for the greatest number of people living with HIV.

Sorry about your recent HIV diagnosis.

I agree with your Consultant that you should start treatment for HIV as soon as possible. This recommendation actually applies to all people living with HIV, and many national as well as the World Health Organization recommend antiretroviral treatment (ART) for all people living with HIV, as soon as they are diagnosed, and irrespective of CD4 cell count or clinical status.

In your particular case, with a CD4 count of 75, your immune function is far below the threshold for an AIDS diagnosis (200) so the risk of delaying initiation of treatment is very significant- given you know your diagnosis and are linked to medical care, procrastinating at this point only jeopardizes having a life-threatening infection (like pneumonia) or cancer.

Now I hope that your question incorrectly listed tenofovir as your only HIV medication. Tenofovir monotherapy is not a recommended regimen at all- as monotherapy is associated with very rapid development of irreversible viral drug resistance. That said, tenofovir is a widely recommended and used component of many excellent initial 3 drug HIV treatment regimens. Make sure that your consultant doctor has prescribed a 3 drug regimen before starting on a single drug.

I hope that's helpful, BY

Titers decrease beyond 4 fold in 3 months then back up in 3 weeks help
HIV diagnosis as April 10 now may 11 no treatment

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