Should I start on meds yet?

[Morto]

I was diagnosed in Feb 2011, my test results have been:

March 2011
CD4: 492
Viral: 4100

April 2011
CD4: 637
Viral: 8000

September 2011
CD4: 716
Viral: 22,000

April 2012
CD4: 468
Viral: 6700

July 2012
CD4: 474
Viral: 6000

September 2012
CD4: 465
Viral: 6700

April 2013
CD4: 356
Viral: 6000

After my last test, my doctor has asked me to come and visit him soon for another blood test and to discuss possibly starting treatment.

My personal opinion is that I really don't want to start treatment just yet, I notoriously suffer side effects from medication and I've just started a new job that I desperately don't want to be jeopardized by side effects of any treatment. Saying this, I absolutely do not intend to put off treatment if I really need it - but if it can wait then I am happy to let it wait.


So I guess my questions are:
Considering my low viral load, can I delay treatment?
Is there anything I can do to increase my CD4 without treatment?
I was mega sleepy on the day I had my last test, could this have caused my CD4 to be low?
I've only been poz for 2 years, is this unusually fast progression?

Thank you for reading and I'm happy to be part of this community.

[Matts]

I would start treatment with this low CD4 count- I think its borderline.
Almost certainly You won't have  side effects with the modern drugs.
Good luck

[mecch]

I've only been poz for 2 years, is this unusually fast progression?

Looking at your numbers over two years, it looks stable to me. I don't know why you think its progression.  First of all, these days, these categories such as "fast progression", IMO, don't carry much meaning to an individual. THe drugs are quite good and if someone has access to drugs and medical care, then the individual starts when he's ready in combination with when the doctor advises. Secondly, I haven't heard that these days it makes much difference 10 or 20 years down the road of life if one is advised to start after 2 months, 2 years, or 10 years.  In fact, starting at diagnosis, no matter the viral load or CD4 count, is increasing considered a fine choice.

So don't be worried about putting yourself into a category of fast or slow progressor. Just start when you and your doc agree its a good idea. 

And it doesn't look like waiting a few months into your new job, to start, will make any difference.

However, if generally, you are feeling some fatigue, it might be GOOD for your new job to be on HAART, and probably getting the energy boost many report after starting. 

All the "effects" of HAART are not bad.  Many are experienced in the body as quite GOOD.

[buginme2]

So I guess my questions are:
Considering my low viral load, can I delay treatment?

You have already delayed treatment.  Can you delay further?  Sure.  You have to decide at what point to start.  Do you wait until you develop some infection or other complication and have to start treatment.  If yes, you can continue waiting.  Do you intend to start before developing any infection or complication in order to prevent that from happening and preserving your immune system as best you can?  If yes, then you should consider starting sooner rather than later.

Is there anything I can do to increase my CD4 without treatment? Other than starting medication, NO

I was mega sleepy on the day I had my last test, could this have caused my CD4 to be low? CD4 counts fluctuate regardless of what you are doing.  Blame it on the weather if you want.  Regardless of the reason, it is what it is.  

I've only been poz for 2 years, is this unusually fast progression? NO

Edited to add:  Read the history of the "Should I start treatment" threads, there are hundreds of them.  They all have the same theme.  Someone is scared to start, starts, comes back and posts how they wished they had started sooner.  I dont think I have read a post (maybe there is one or two) from someone saying they wis they had waited to start treatment a little longer.  Just saying.