did they make me start to early

Mar 2, 2005

Hi I tested positive for HIV in july 2004, I had swollen glands and ulcers in my throat around march and that is when my doctors think I seroconverted. In July my viral load was 150 000 and my cd4 was between 450-500 , 2 weeks later my viral load was down to 750 000 and 2 months later up to 80 000 and now in dec 2004 around 67 000 - my viral load has gone from 450 -318 -370. I started my meds with my vl at 67 000 and cd4 at 370. I am on sustiva, viread and 3tc. do you think I should have waited for a few more months to see if my cd4 and vl became more stable or was I right to start bare in mind the doctors think I was only infected around mar 2004?

many thanks for your help

Response from Dr. Henry

Most HIV experts in the US would be comfortable with the recommendation to start treatment when you did. The SMART study randomizes patients to wait until the CD4 count falls to 250 and then treat (stopping again when CD4 count > 350) versus continuous therapy whatever the CD4. With the newer drugs (easier with less side effects) the right balance between treating early versus late is a moving target without optimal data (thus the SMART study with 6000 patients using actual clinical endpoints and not just blood test results over a 5-6 year period) . KH