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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
           
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starting treatment
Sep 25, 2002

I recently found out in April of this year that I am HIV+. I got a T-cell reading and mine is at 412. Should I start treatment now or later. I see so many conflicting philosophies on this matter. Thanks.

Response from Dr. Henry

There is no definitive answer since we hope to successfully treat patients for decades yet have only 5-6 years experience with effective medications. Alot depends on how one is feeling, the rate of change of CD4 count and RNA levels, personal view towards treatment,etc. The SMART trial run by the CPCRA randomizes persons like yourself to immediate treatment versus delaying until the CD4 count reaches 250 (6ooo patients for 6-9 years)in an effort to get at the answer. Current US guidelines recommend starting treatment if asymptomatic if CD4 < 350. Elsewhere the CD4 threshold for starting therapy ranges from 200-350. Sometimes one simply can start therapy on a trial basis for 6 months and then decide of they want to continue. There are lots of choices (like a good buffet) which can be confusing but overall treatment is getting better. KH



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