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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
          
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Early Treatment
Dec 12, 2003

I was recently diagnosed as HIV+ and can narrow the time period of my infection to July/August of 2003. I probably seroconverted in September. My CD4 count is 675 and my viral load is approximately 220,000.

I luckily had a primary care doctor who has a large HIV practice. He is recommending that I start HIV meds now, use them for the next 12-18 months and then suspend therapy. His thinking is that I will have lower viral loads and higher CD4 counts after the therapy than I would had I never started any medication. By the way, I have low concerns about my ability to adhere to the regimen because I already successfully take daily meds.

I trust my doctor, but the CDC and some AIDS organizations seem to endorse delaying drug therapy until symptomatic or until CD4's are beloe 200. But, I've also read about long-term, irreversible immune-system damage if you wait too long to begin therapy. So, basically all of the information is somewhat conflicting and overwhelming.

Any light you can shed on this topic will be most appreciated and thanks for participating in what I have found to be a very useful forum.

Steve

Response from Dr. Conway

Your doctor is very up to date. Some (including myself) feel that treatment for 12-18 months during the acute phase of HIV infection may lead to long-term control of the infection off therapy. One of the reasons for thinking this is that your immune system would be relatively normal at the time of intervention and that the tissue stores of HIV are not yet fully established. Thus, after one year of treatment, your body may be able to handle the virus on its own, for an indefinite period of time.

However, if you do this, you need to be committed to the approach, to make sure that full virologic suppression is achieved, to avoid drug resistance.



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