I have been fighting a heavy duty cold since thanksgiving which was initially diagnosed as strep. I took anti-biotics for 10 days and was just yesterday 12/31/07 given a new course of antibiotics as i'm still tight chested and coughing up muccus. I've been diagnosed one year and have taken no meds. Are my numbers indicating a need for meds or a response to my chest cold?

I am sorry you have not been feeling well. From an HIV perspective you immune system appears strong with over 600 CD4 cells. The decision as to when to start is very much a personal one that requires a detailed discussion of the pros and cons with your provider. However, current guidelines do not suggest treatment be initiated in people without HIV-related symptoms, such as thrush, until CD4 cells are less than 350 cells/uL. The viral load is less often a reason to consider starting therapy and you are correct that it is possible that a respiratory tract infection could transiently increase this value.

Best, Eric