I am 30 years old, 16 weeks pregnant, just diagnosed HIV+ with a VL of 76000, CD4+ 165, anemic, tired most of the time, not able to concentrate, but HEALTHY. When should I start medication?

Hi,

When should you start medication??? The best time would have been a number of months ago when your CD4 cell count was much higher! The next best time is now! You need to start immediately for two reasons. First, your health. You are not as "healthy" as you might think or seem. You have AIDS and your immune system is severely deficient, leaving you (and your baby) with increased susceptibility to opportunistic infections and malignancies. Beginning combination antiretroviral therapy now will hopefully inhibit HIV viral replication, driving your HIV plasma viral load to undetectable levels and thereby allowing some degree of immune reconstitution (increasing CD4 cells). The second reason to start is your unborn child! Effective antiretroviral therapy will significantly decrease the risk of passing your HIV infection onto your baby. You need to work closely with an HIV specialist and an HIV-knowledgeable obstetrician. Don't delay! Your health as well as that of your unborn child is at stake!

I'd suggest you spend some time reading through the wealth of information on this site, in its archives and on the related links. Begin with "The Basics," which can be easily accessed on The Body's homepage. You can then proceed onto the expert forums and their archives.

Good luck!

Dr. Bob