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Early Meds or wait until CD4 drops?
Jan 23, 2010

I was infected with HIV-1 on 10/2007 (Approx) and diagnosed on 12/15/2007. The labs are as follows: On 03/19/08 CD4 580, CD% 32, VL 8,160. On 12/15/08 CD4 684, CD% 31 and VL 1,628. On 08/21/09 CD4 543, CD% 35, VL 544. I am 34 years old, I feel excellent, I have no other illness and I am not on meds yet.

After reviewing a lot of primary studies about start taking the meds as soon as possible instead wait for your CD4 to drop to 350, I will gently appreciated if you can please share with me your thoughts about it (if you where me which will be your decision wait or start ASAP - please dont tell me that It depends on your beliefs about the virus and taking meds)

Then, if your suggestion is start on meds, with my current low VL do you think that will be possible to do the drug resistance?

Thanks again and again Dr, Please count with $50 donation for your foundation

Response from Dr. Frascino

Hi,

I've addressed this topic many times before in this forum. Check the archives! Personally, I would start combination antiretroviral therapy immediately in the hopes of preserving immune function and decreasing immune activation. That said, I must quickly add we do not have clinical studies definitively concluding this is the correct thing to do in all cases. But you asked what I personally would do.

Resistance testing can routinely be accomplished with levels over 1,000 copies/ml. Some can be done at levels between 500 and 1,000.

Thank you for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's greatly appreciated.

Be well.

Dr. Bob



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