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Should I be on Medication

Sep 2, 2007

I was diagnosed as HIV+ in Aug 06, my CD4 was 553 and Viral Load 200,000. In Feb 07 CD4 was 479 and Vir Load 264,000. In June 07 CD4 was back up to 553 and no Viral check was done. My doctor said he dosent want to put me on any meds until CD4 drops to 250? What' your thoughts?

Response from Dr. Horwath

Antiretroviral therapy (ART) is recommended for all people who have had an AIDS-defining illness or other severe symptoms of HIV infection, regardless of the CD4 cell count.

For those who are HIV infected and haven't had an AIDS-defining illness or symptoms, the decision to treat depends mostly on the CD4 count. For those with CD4<350, treatment is usually recommended. For those with CD4 >350, treatment is usually deferred.

However, some doctors recommend starting treatment in those with CD4>350 and HIV RNA > 100,000 copies/mL. This is a decision based on weighing the benefits of treatment against the toxic side effects of treatment. In patients who don't have symptoms and have CD4>350, the risks of treatment are thought to outweigh any benefits in most people.

With your CD4 counts, treatment does not appear to be indicated unless you have had significant symptoms. You should discuss this with your doctor. He is giving sensible advice.

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