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Recently Diagonsed & Confused
Sep 15, 2010

I have been recently diagonosed positive, it was a routine call to the STI clinic and this came as a shock. My first blood work results have come and it shows a viral load of 5491 copies and a CD4 count of 650. My doctor has asked me for another blood work and asked to see me after a month. Looking at my results, can you judge when i could have been infected? When would i require to start medication? Is starting medications earlier would be better in the long run? I am reading all the side effects of HAART and am quite scared. Many thanks for your help.

Response from Mr. Vergel

I think your question is one of the most common ones lately.

There is no way to know when you got infected by just looking at your HIV viral load, CD4 cells, and other tests done in people who are recently diagnosed.

Your CD4 cells are over 500. The current US guidelines say that those with CD4 over 500 do not need to go on treatment unless they want to or if they are positive to Hepatitis B. I am assuming you have been tested for hepatitis B.

Assuming you are in the United States, the most commonly "first line" therapies (first line meaning that they are prescribed as the first combination to people who have never taken medications before) are:

1- Atripla (which is Sustiva plus Truvada in one pill once a day)

2- Reyataz plus Norvir plus Truvada ( 3 pills once a day)

3- Isentress plus Truvada (one pill of Isentress twice a day plus on pill of Truvada once a day)

These three regimens are more friendly than the ones we used to use in the past when it comes to side effects. We are not seeing facial wasting and huge bellies as much as we used to. We are not seeing as much diarrhea and neuropathy either (this statement applies to treatment naive patients who start these regimens, but we are still seeing some issues in long term survivors who were exposed to more toxic agents in the past)

Starting treatment is a personal decision that you should discuss with your doctor. Some patients and clinicians believe that the earlier one starts treatment, even above 500 CD4 cells, the better. And some doctors only follow current guidelines and advise the patient to defer treatment and come back every 3-4 months for blood work.

Nelson



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