CD4 = 127 - should I start treatment or delay?

Question

Hello, I would much appreciate your specialist opinion on my particular situation: I am a white female of 43 y.o. I have just been diagnosed with HIV and I have a CD4 of 127. I haven't received yet the results of my VL but I expect to be high. I have been infected in 2004 and diagnosed in 2009, so it's been six years while I was not aware of having HIV. This year I started having itchy facial rashes and an enlarged salivary gland, regularly hair loss and this is how I found out. Otherwise I am healthy, just red cell are on the edge at 1200. I was offered by the doctor to start Atripla once a day and Co-trimoxazole once a day until I get my CD4 up to 200. I am taking the Co-trimoxazole but I am thinking of delaying to take the Atripla for two months and try to build up my immunity with the herbal supplement Astragalus, vitamins and herbal products. Can I safely try and do this or am I at risk of cancers and infections if I don't start taking Atripla immediately? Why can't immunity be built up without Antiretrovirals? If I start taking the meds now at CD4 = 127 or later, let's say at CD4 = 50 worse scenario, what will be the difference in terms of my prospects of recovery? Thanks very much for your help. A quick answer would be much appreciated as I'm not quite ready to die yet, just like this...God bless you!

Answer

You need to start the HIV meds immediately. DO NOT delay and I would not rely on herbals to increase your CD4 count or immune system function. There is a huge loss of immune system function if you wait until your CD4 count reaches 50, and you are already at significant risk for opportunistic infections now, which would only be magnified. There is no reason to delay and Atripla is a good choice.