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Jun 29, 2002

Please answer this........I just found out that I am Hiv+ 3 days ago. If that is not enough......I have my doctor and an I.D. doctor telling me to start combivir and Ziagen which I already got the meds to start. Their reasoning: my infection is acute about 6 wks ago, and get it while it's still new. I went yesterday to participate in a a major ongoing hiv study in my city. The Dr's there told me to wait viral load is only 16,000, and why put myself through unwanted side effects when i really am quite healthy My T cells are still 700. I am very confused what to do .....I am afraid to start the meds unnecessarily, but i am also afraid not too.... Can someone help me in deciding or shedding some light on the pros and cons. I would appreciate your help as I am very confused and emotional THANK YOU ..

Response from Dr. Young

Thanks for your question.

You've raised very important issues about starting therapy during acute infection.

There are several reasons for the recommendation about starting therapy during acute infection. Many of these have been outlined in previous answers on this forum and in TheBody. Basically stated, there appear to be some unique advantages to starting early- namely the preservation of HIV-specific immunity. This is the immunity that is resposible for controlling HIV, and perhaps it is the preservation of part of the immune system that might later be the basis of meaningful immunological control of the virus (i.e, therapeutic vaccination).

Is this potential benefit of sufficient basis to recommend treatment for everyone during acute infection? I'd have to think not, given that this is a theoretical benefit, yet to have proven long-term health benefits. Indeed, the use of initial therapy is offset by the risk of side effects and the genesis of drug-resistant virus (though poor adherence to medications). This brings up one important point, which is, it would be recommended to make sure that your doctor (or study coordinator) obtain a HIV genotype now, since this time should accurately capture the drug susceptibility of your virus.

Indeed, this is a very emotional time; starting on therapy in this period is stressful and emotion-packed. I'd want you to be sure that this is the right time for you, that you understand the potential benefits of starting now, as well as the potential down-side of not starting now. Invest the time in finding the answers to your questions; particularly spend time speaking with the study investigators about the risks and benefits of starting on their study.

Stay in touch, and feel free to write back. -BY

What is 908? Dr wants me on it....
A colleague from Italy need Your appreciable opinion.

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