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what are best first steps?
May 27, 2001

I recently was diagnosed as HIV POS, my first tests revealed undetectable viral load and cd4 0f 600. Six weeks later my viral load was 1500 and mt cd 4 was at 703. Should I try to put off meds as long as possible, or begin them. I have a follow up with my specialist in 3 weeks and want to have a better sense of direction before we proceed. I was researching Proleukin along with natyural herbs to boost the immune system. Thanx

Response from Dr. Young

Thanks for your question.

For purposes of discussion , I will assume that you are not acutely seroconverting (having acute retroviral syndrome). This being the case, recent guidelines have suggested that persons with CD4 counts above 350 and low viral loads (such as yours) can consider deferring on the initiation of antiretroviral therapy.

This position is based on understanding the balance between the benefits and potential risks of therapy, particularly for persons like yourself with very low viral loads. The MACS cohort study has shown us that the risk of HIV disease progression is proportional to the level of HIV viral load; hence for you, your immediate risk of disease progression is very low. Waiting to initiate HIV treatment does not imply no follow up laboratory monitoring; careful monitoring can help identify when is the best time to start; hopefully at at time when treatment science has improved even further, with drugs that are easier to be adherent to, more forgiving and easier to take.

Hope this helps, BY



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