I tested HIV-positive last month.

My initial set of numbers are; cd4 434, vl 88,000 & 24.1.

I have had persistent oral and esophageal thrush/candida for approximately 8 months. It clears up with Diflucan, but returns within days after the medication stops.

Would you recommend starting treatment at this point?

I'm really very scared. Any input you could provide would be greatly appreciated.

Thank you for your time and God bless you for the work that you do.

Thank you for your question.

The question of when to start therapy for HIV has become somewhat controversial lately. In the past, most clinicians would definately start therapy in persons with CD4 counts below 500 cells, particularly those with viral loads like yours, over 50,000 copies.

Recent opinion has become more conservative, with the breakpoint for initiation of therapy lowered to 350 cells.

Nevertheless, I would sum up your situation as someone with mildly symptomatic (thrush) disease with relatively high viral load and moderate depletion of CD4 cells. If you were in my clinic and were willing to start therapy, able to adhere to the treatment regimen and had good social supports, I would offer you therapy.

It would be very important to weigh all the pros and cons of starting treatment and to tailor the medications to your particular needs and aversions.

Hope this is helpful. BY