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Recently exposed/diagnosed. . .should I seek treatment
Nov 13, 2000

I was recently diagnosed with HIV, and I contracted it within the last 2-3 months. I was wondering when the best time to start treatment is? I have read where researchers and doctors think that getting treatment within the first 6 months of infection can change the entire course of the disease, but there seems to be a lot of unknowns involved in that. I'm really scared of the insurance ramifications/problems that very early treatment could cause for me later .

Response from Dr. Cohen

Well, you don't mention where you are or what your treating clinicians have said to you about this issue. However the data about treating at this point were recently published - and have been summarized on this web site in the past year (see conference summary from last december from a conference here in Boston that I summarized for more details.)

Yes there are unknowns - and no guarantees. But there does appear to be an opportunity only very early on to alter the "set point" of the viral load of HIV in a way that may profoundly prolong the time you can remain well without meds in the future. When treatment is started early on, and then some manipulations are made later on with treatment interruption, there is a pretty consistent theme of seeing a prolonged time with a very low viral load that can stay low without meds. The immune system can be harnessed - but only a few will do this naturally. Others, through early treatment, might be able to join them - at least for periods of time.

As for insurance concerns - while there is always room for concern here, there is however the potential to alter how your body handles HIV in a way that may have lifelong implications for you. I am not sure exactly what your concerns are - but hopefully your insurance actually allows you to treat illness, not worry more that you have it and might lose insurance. There might even be studies where you are about this - there could be some work being done at the NIH that could provide meds and testing for free and could be worth a call. You might try calling 1800 TRIALSA in the US and see if the NIH has anything for your consideration.

Good luck.

CC

Cal Cohen, M.D., M.S.



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