Hi Doc, I have seen two HIV Specialists and have been given two opinions on when to start treatment, can you help? I had a bad Seroconversion on the 1st Feb 2006 and was hospitalised for two night lost 8kg and 40 temp over three nights. One month after that vl was <100000 and CT4 200. Then 6 weeks later vl 56000 and CT4 520 but 14%.

I am feeling fine but I am getting very dry and itching skin over the last month and also skin reations, so Doc put mevon antibiotics. Should the skin irritations go away when counts improve?

Should I start treatment on those counts and the fact that I am getting skin irritations or wait? Thankyou for your input. AD

No clear consensus as to how to proceed in your best long term health interest. If you are having symptoms still then a trial of a regimen for 6 months using a fairly resistance proof regimen (boosted protease inhibitor) is an approach I use sometimes. I then discuss with the patient what they would like to do depending on how they are feeling and their blood test response. My general appraoch would be not to treat with a CD4 count >> 350 and follow closely but one situation where I alter that is in situations like your-thus I am giving you a split opinion (but honest). KH