Feb 20, 2002
Hi how are u see my tcells are 375 and my viral load is over a thousand and my doctor says she does not have to start me on any medication yet what do u think about that.
Response from Dr. Henry
The decision of when to start treatment is a difficult one. CUrrent US treatment guidelines suggest that in an asymptomatic person with a low viral load (such as < 30,000 copies/ml) waiting until the T-helper cell count is less than 350 is OK. There is a large study (CPCRA SMART Trial) that is examining whether it is better over the long term to start therapy immediately or wait until the T-helper cell count is < 250 (and then treating until the T-helper cell count > 350 then stopping treatment until less than 250 again). We simply don't know what is the best thing to do for either individual patients or populations. The treatments continue to improve so the choices are getting better as time goes on. The discussion about when to start is often a long one between your doctor and you. THe current US guidelines can be found at www.hivatis.org---look under current library of guidelines for treatment of adults (last updated Feb 4, 2002). KH
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