Hello

I have had HIV for over a year. My vial load was 70,000 in May. I was tested again in August and im now at 314,000. My CD4 is 460. Should I ask to be placed on medication because my viral load is so high?

This is a question that many people have. Current "Guidelines" on when to start therapy use CD4 counts as the major factor to decide when to start treatment, and use viral load as a secondary factor. High viral loads (over 100,000) require more careful and close monitoring because a high viral load can drive the CD4 count down more quickly. We also must consider other things when deciding on the best time for treatment such as: presence of hepatitis B or C (which may prompt earlier treatment for HIV), age, willingness of the person to take medication every day without fail, HIV related kidney problems, or to help reduce the chance of spreading the virus to a negative partner. This is an individual decision. Close monitoring to make sure the CD4 count remains stable is an option if you are not ready for treatment. If you are ready to start and want to get the viral load undetectable and keep your CD4 count from dropping then that would also be appropriate. You should have a frank discussion of the risks and benefits of treatment for you as an individual with your medical provider to make a plan you can live with.

Good luck, Joe