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Starting Early | Treatment Guidelines | Deciding Whether to Start Meds | Pregnancy and Starting Treatment | Resistance

Starting Early

• As an expert on HIV, if you were diagnosed today, would you start treatment right away no matter what?
• What's considered starting "early" versus starting "late"?
• I keep reading that the new drugs have few side effects. If I am going to be on treatment for many years anyway, why should I wait to start instead of beginning treatment immediately?
• Could starting HIV treatment shortly after being infected protect my immune system from long-term damage?
• My CD4 count is high (700) and my viral load isn't too bad (15,000), but I want to reduce my transmission risk as much as possible. My doctor keeps telling me that HIV meds are "not recommended" right now, but can he actually prohibit me from starting treatment?
• I started treatment when my viral load was 80,000 and my CD4 count was about 900. There seems to be a lot of conflicting information in the medical literature about when to start HIV treatment. Did I start too early?
• My viral load was greater than 10 million, while my CD4 count was 330, so my doctor started me on meds. Ten weeks after starting, my viral load is undetectable and my CD4 count is 500. I know this is all great news, but should I really have started treatment so quickly?

Treatment Guidelines

• Which HIV drug regimens are most commonly recommended for people starting treatment?
• I know that HIV treatment guidelines recommend starting meds at a CD4 count of 350, and my CD4 count is above that. But my CD4 count is also dropping, and that has me worried. Should I start treatment anyway?
• My friend was recently diagnosed with HIV and told not to start medication until his CD4 count falls below 200. Is that too late?
• I've noticed over the years that you've recommended starting HIV meds at higher and higher CD4 counts. First the number was 200, then it was 250, and now the consensus is to start at 350. What's the deal?
• My 10-year-old son was recently infected by accident. Is he too young to start treatment? What are the best choices of meds to ensure he's able to take them all properly?

Deciding Whether to Start Meds

• I've read that being on meds for too long isn't good and that it's better to just start taking them at the recommended time. But I also don't want to put my health at risk. How do I figure out what's best for me?
• Is a low CD4 count enough reason to start treatment, even if I feel like I'm not ready?
• My father's CD4 count is around 350. He seems very healthy, so can he delay starting treatment?
• I am 70 years old and recently tested positive. Because of my age, should I start medication sooner than is recommended for younger people?
• I've been HIV positive for eight years, and lately I've been getting mouth sores that don't heal quickly. Does this mean I need to start HIV meds?
• I was recently diagnosed with HIV. My CD4 count is 400 and my viral load is 30,000. My doctor has put me on Bactrim, which protects against pneumocystis pneumonia (PCP). Should I start HIV meds as well?
• I've been living with HIV for 24 years. My CD4 count has been between 490 and 520 for the past 10 or so years, and my viral load is 2,200. What are some of the pros and cons to starting treatment now?
• My CD4 count was 565 but after 10 months, it dropped very quickly to 388. My doctor thinks this drop is rather unusual and wants me to start HIV meds soon. Is my doc right?

Pregnancy and Starting Treatment

• I was recently diagnosed with HIV and am 16 weeks pregnant. My viral load is 76,000 and CD4 count is 165, but I feel healthy. When should I start medication?
• I was recently diagnosed and have a CD4 count of 750. My doctor says I should wait before starting treatment. If I want to have a baby, is there an ideal CD4 count for getting pregnant? Once I start treatment to prevent transmitting HIV to my baby, will I have to stay on it forever?
• I've just completed my first trimester of pregnancy. My viral load was a little above 1,000 before my pregnancy, and my CD4 count was 820. Should I start treatment at this point?

Resistance

• Is it possible for someone's virus to be resistant to all HIV meds? How likely is a person to be infected with a virus that's already multidrug resistant?
• I've never been on HIV meds, but my virus is partly resistant to some NRTIs. How will this affect my options for first-line HIV treatment?
• I was recently diagnosed with HIV, but because my viral load was very low, a genotype test for drug resistance couldn't be performed. My doctor seems to be in favor of starting treatment early. Is it safe to start HIV meds without genotype test results?

For frequently asked questions on other HIV/AIDS topics, click here.