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Minimum level of CD4 for Anti-viral Treatment Start
Apr 4, 2001

1. What is the CD4 level, that one needs to have before starting Anti-viral drug treatment?

2. I'm practicing safe sex, but though I can do other jobs, I'm becoming sexually impontent. The only 'medication' I'm taking are food suppliments. This is affecting myslf and my partner psycologically. Please help!

Response from Dr. Boyle

The current DHHS guidelines recommend starting antiretroviral therapy in an asymptomatic patient when the CD4+ cell count is between 200 and 350 cells/mm3 or the viral load is greater than 55,000 copies/mL (PCR). Of course, as the guidelines discuss, the starting point is ultimately up to the doctor and the patient and their consideration of many factors, including the degree of immunodeficiency that is apparent, the risk of disease progression, and the willingness of the patient to start therapy. Regarding your becoming sexually impotent, this is something you should discuss with your doctor. There are many things that can cause this, but by far the most common in my patients is testicular dysfunction, which can be corrected by testosterone replacement.



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