I have been tested positive two years ago. My CD4 have gone down from 500 to an actual 300, my virual load has been high ever since and is now at 300.000. It seems that most U.S. doctors would have started HAART already whereas my German doctor will only really start to push me when I go below a CD4 count of 250 regardsless of the virul load. What is your opinion on that?
Thanks a lot and best regards from Germany!
Doctors vary in their views on when exactly to start therapy. In the US we do tend to start earlier than in Europe but whether this is better or not is not completely clear.
In all actuality the difference between a CD4 cell count of 250 and 300 is likely fairly small - if there is a difference at all. If you are eager and ready physically and emotionally to start HIV therapy now, especially since you have a high viral load, I would ask your doctor to be flexible and understand. You can also try and ask the doctor to share what she/he would do if they were in your shoes.
If he/she indicates there are other reasons for their hesitation (concern about your ability to adhere to therapy, other illnesses, etc) hear her/him out. They may be right.