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Not on treatment yet
Jan 10, 2008

It is 8 years now since I found out that I am HIV+.My partner passed away after a short illness 2 yrs ago.I am begining to have mouth ulcers which do not heal quickly.Am I at danger or should I start on treatment.I just take immune boosters like canova.

Response from Dr. Sherer

You should see an experienced HIV doctor or clinician, get a complete assessment, and then decide. The presence of oral sores alone would not necessarily be an indication for ART, but it would be a factor to consider. These can be painful and interfere with the quality of your life, and may be only responsive to ART. On the other hand, there are many possible causes for mouth sores, and HIV may not be the cause.

Your question concerns me because you did not include your current CD4 cell count and viral load. These two lab tests, together with your current clinical situation, would form the basis of the decision as to whether or not you need to be treated with ART now. In general, current guidelines recommend treatment when the CD4 cell count falls below 350 cells/ml. A viral load above 100,000 copies/ml would also be a factor favoring ART.

While I would have no objection to your using dietary supplements, I would caution you that there are no data to suggest that canova or other so-called 'immune stimulants' are better than placebo in boosting the immune system, and I would caution you NOT to think of this as meaningful treatment for HIV infection.

I have attached the link for the current HHS Treatment Guidelines that describe the current indications for ART.

In sum, find a doctor or return to your current doctor to address this question, and feel free to share this email response to your question.

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