Sep 19, 2007
Hi I very recently found out that i'm HIV positive, my cd4 is 440 don't know what the viral load is yet. but my doctors seem to think that i'll be fine, after reeding some articles on this subject i'm not sure anymore if my doctors are correct, I mean should I be on meds with a cd4 count like that?
Response from Dr. Henry
In the US currently the typical CD4 threshold for recommending antiretroviral therapy is < 350. That recommendation comes from studies noting a relatively low short term (ie 3 year) risk to develop AIDS for persons with CD4 counts > 350. A new consideration is the risk for non-AIDS but possibly HIV-related conditions such as heart disease and cancer that may be modestly increased in presons with CD4 counts < 500. If a patient is symptomatic, has a rapidly dropping CD4 count and/or a high viral load (ie > 100,000 copies/ml) then treatment is often considered at higher CD4 counts. The presence of other conditions (ie hepatitis B or C), mental health status, chemical dependency issues, housing, readiness to committ to long-term treatment, risk behavior levels with sexual/needle partners, and many other factors enter into what is often a highly individualized decision about the best time to start treatment for a given patient. Access to quality HIV care including uninterrupted access to antiretroviral therapy is a big hurdle for many in the US and throughout the world.
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