May 20, 2004
Hi, I'm 21 and recently found out that I am HIV positive, I'm from the Caribbean , I did the C4 blood test and such. What I wanted to ask was - I was told that I had a C4 count of 393 and that I won't be put on treatment until my count reaches 250 or lower - can you tell me is my immunes system considered to be in a good state as that doctor claimed? shouldn't I be on treatment already?
Response from Dr. Henry
If a patient has HIV related symptoms HIV treatment should be considered no matter what the CD4 count is. If the viral load is very high (i.e. 100,000 copies/ml) then therapy is also considered possibly helpful even at a somewhat higher CD4 count. In the US the current recommendation is to consider therapy with a CD4 count < 350--that is generally the threshold I use more often though there are studies comparing 250 versus 350. Usually the risk to develop AIDS over the next 3 years is low if the CD4 count is > 350 and the patient does not have symptoms and the viral load is < 100,000. In that situation I usually focus on other health/social issues and education while monitoring the patient every 3-6 months. KH
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