Dear Doctor can you please help me, 2 months ago my girlfriend was told she had HIV we went for a VL and CD4 her numbers were 2900 VL 533 CD4. I am western and my girlfriend is Thai we have been together 4 years. The hospital we used has a good reputation and the doc there said she should not start meds until her CD4 drops below 200 and VL is above 20,000. Why does most of your website say its best to start meds between 200-350 CD4 and above 55,000 VL i dont want to tell the Thai doctor how to her job but i worry they might not know enough about it all i want is the best possible care for her. Also i asked my girl if she had any Vacinations during her life time and she said she had a booster shot in her arm when she was at school and that was it so do you recomend her to get any type of shots like Influenza, Hep b, Hep c, polio, like the ones i have got. Is there problems with HIV people to recive these types of shots im so worried that the thai people dont know enough as they have a dim look on life being budda and thinking of reincarnation. Please if you can help and answer my question i would much appriciate it. Kind Regards

The medicines for HIV are very expensive. Each country has to make decisions (based upon science and economics) about when and how to treat this disease. Therefore, while we generally refer to recommendations for people in countries where medicines are readily available, there may be different recommendations based upon the disease and it's ramifications in different countries.

The vaccination recommendations are also different based upon the country in which you live. Most often Hepatitis B vaccination, updated tetanus immunizations, and probably Pnuemovax would be good to consider.

Talk to her doc about your questions.

Be well.