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In grey area with some symptoms -- Treatment? Medication?

Sep 5, 2000

I was diagnosed HIV positive two months ago. This weeks tests show viral load of 9000, CD4 of 450 and P of 3. I've yet to see the doctor, but nurse tells me I'm in the subjective grey area where medication is as much my decision as a medical necessity at this time.

I've discussed the benefits of early treatment with her and will do so with the doc next week. From what I've read, low viral load = longer life. Why not start treatment now and lower the count to undetectable levels? Wouldn't that minimize my chance of contracting an OI, prolong my life and improve my quality of life in the long run?

Response from Dr. Squires

Your questions are good ones; you do need to discuss these with your physician. You are correct that a number of studies have indicated that the lower the viral load, the lower the risk of experiencing progression of your HIV infection -- further decline of your CD4 cell counts, development of an OI, etc. However, as people have been taking combination regimens over the past several years, a number of long term complications have become apparent. In addition, once therapy is started, it appears that it may be life-long since our current understanding of this infection indicates that we cannot cure it with the drugs that we have. Therefore, we have to balance the benefits of treatment with the risks and complications of the therapy that occurs in some people along with the problem of being able to take a drug regimen over many years. Ultimately, it is your decision, along with your physician, as to the best time to start therapy after you have considered all the options.

Hope that this has been helpful. Good luck with your decision.


Kathleen E. Squires, M.D.

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