The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App 
Professionals >> Visit The Body PROThe Body en Espanol
Ask the Experts About

Safe Sex and HIV PreventionSafe Sex and HIV Prevention
Rollover images to visit our other forums!
Recent AnswersAsk a Question
  • Email Email
  • Glossary Glossary


Mar 27, 2010

Dear doctor, I'm brazilian 43 years olds, HIV positive since 1999 and viral load 10.200 and CD4 364. My infectologist has decided not to start The Haart Therapy and wait 2 months. In Brazil, the consense is to start the treatment about 200 CD4+. I'm cocaine adction in treatment and my doc is worried about meds and drugs. What Your opinion?

Sincerely, Walter

Response from Dr. Frascino

Hi Walter,

There are several issues to consider here. First would be how are you doing with your drug rehabilitation program. It's possible your doctor is concerned that you might fall off the wagon. Coke-heads and others addicted to illegal substances can have difficulty adhering to antiretroviral therapy dosage schedules. If adherence is not excellent, you could develop drug resistance. Antiretroviral drug resistance can make your infection much more difficult to treat. Some HIV specialists prefer to wait until the drug addiction is under control for this reason.

The other issue concerns the best time to start combination antiretroviral therapy. In general the consensus is once again swinging toward earlier intervention. As an immunologist, I can advise you that it makes excellent immunologic sense to begin treatment as soon as possible to preserve immune function and decrease immune activation. However, these beneficial immunologic effects need to be weighed against potential negative consequences, including drug side effects/toxicity, cost, need to take mediations on a regular schedule, etc.

From an immunologic perspective, I would not wait until your CD4 count falls into the 200-count range. If you feel you can adhere to your regimen and you are psychologically ready to start, talk to your HIV specialist and get started now. You can read much more about "when to start" in the archives. Take a look and consider showing some of this information to your HIV specialist.

Good luck Walter.

Dr. Bob

Dr. Bob - Can I Woo Hoo Now?
Big Worry + How to deal with a Partner reluctant to talk about HIV

  • Email Email
  • Glossary Glossary

 Get Email Notifications When This Forum Updates or Subscribe With RSS



This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint