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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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RE: too early to have begun treatment?
Feb 8, 2005

I had a very similar experince when I went to the doctor with low-grade fevers, night sweats & a red "burn-like" hot rash. I found I was HIV+, but also found I had contracted syphilis. I started meds about 2 weeks after penicillin treatment. My VL was 330,000 and my cd4 290. My doctor did tell me that Viral Load tests can be driven way up by the material produced by other infections such as syphilis. As I understand it, PCR tests don't count actual HIV virus particles, but the byproducts produced by many types of infectious agents, correct? I don't regret starting meds, but I often wonder if my counts were significantly inflated by the co-infection, and if they might have gone way down had I waited for the syphilis titers to decrease.

Response from Dr. Conway

The PCR test actually does count viral particles, the number of which may be artificially increased due to certain co-infections, including syphilis.

With a CD4 count of 290, it was still a good idea for you to consider treatment, irrespective of the viral load. This is especially true if you know that you were only recently infected with HIV (within the past few months).

If you are chronically infected and you had waited, it is unlikely your CD4 count would have risen much, even if your viral load had gone down. Thus, treatment is beneficial in reducing or reversing immune disease.

If you are acutely infected and you had waited, you would have lost the possible benefit of therapy to preserve the immune system and possibly limit the establishment of viral reservoirs.

You can certainly rest easy with your decision, as long as you are adherent to therapy...

Mycobacterium avium
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