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CD4 count 299.....should i start it now?
Feb 12, 2005


my cd4 count is 299,as far as what i have read you should start therapy once your cd4 drops to 300,should i start the treatment now?



Response from Dr. Sherer

You certainly should be asking this question, but getting to the answer is a matter for you and your doctor, with all of your relevant information at hand.

To help with this decision, I would also want to know: What was the last CD4 cell count and percentage, and when was that done? What have the trends been over time? What is the current level of your viral load, and what have those trends been over time? How do you feel about antiretroviral therapy (ART)? What do you think is the likelihood that you will be able to adhere to your medications? When did you acquire HIV, and under what circumstances? Was a genotype done then? Have you had a genotype recently, and, if so, what were the results? Are there possible side effects of ART that you are aware of that concern you? Are there any that you simply could not tolerate at all? Or others that you might be willing to experience in the short term? Or in the long term? Are you taking any other medications regularly? If so, what has been your experience at regularly taking them? Have they caused any side effects? If you did start ART, would you prefer a regimen that requires dosing only once daily, or would a twice daily regimen also be acceptable? Does the number of pills per day concern you?

My own practice, consistent with the HHS Guidelines, is to start talking to patients about ART when their CD4 cells are around 350 cells/ml, and/or when their viral load is above 100,000 copies/ml. If they want my opinion, I will generally recommend starting therapy if either of these conditions are met, and if they are informed and ready to start ART.

I urge you to talk to your physician about these issues.

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