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When does one need HIV treatment?
Jul 21, 2004

My bf who has HIV got his first CD4 count, he's currently between 500-600. His doctor says that he's doing find and doesn't need any treatment at this point (not until it falls below 400). Is the doctor's recommendation correct? Why is it that my bf doesn't need medication? Shouldn't the medication help prevent the CD4 count from falling below a certain point? Why is it that he needs to wait till he's under 400 to take the meds? Where can I find more information on hiv meds? thanks.

Response from Dr. Horwath

The current treatment guidelines by the Department of Health and Human Services recommend definite treatment for those who are HIV+ and have symptoms and those with CD4 count < 200; they recommend offering treatment if the CD4 count falls below 350; and they recommend considering teatment for those with CD4 count >350 and viral load > 55,000.

The main complications of HIV infection, such as opportunistic infections, start to happen when the CD4 count falls below 350. Starting treatment before that time is problematic due to the side effects of antiretroviral medications, some of which progress during lengthy treatment. Therefore, the decision to start treatment involves balancing the risks of treatment (adverse effects) against the benefits of treatment (preventing complications of HIV infection). The timing of treatment onset varies from person to person based on their individual history, symptoms, treatment preferences, etc.

You can view the DHHS guidelines at



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