Treatment During Primary Infection?

[poly2]

I seroconverted about 6 weeks ago.  I am considering starting early treatment as some research suggests that there might be some advantage to starting treatment in this early window.  At 3 weeks my CD4 was 730 VL 233,000.  At 5 weeks CD4 670 VL 128,000.  I think I am now just getting over the acute phase.  How tolerable are the drugs?  My doctor suggested starting on Reyataz and Epzicom.  I intend to decide very soon whether to treat now or wait, but I would like to hear what people that are actually being treated think about this to help me make the decision.  Thank you!!   

[ScottPhxAZ]

Hi Poly2,

Last year I was diagnosed at about 3 weeks infected. At that time I could find nothing but guesses as far as whether early treatment was good or bad or indifferent. Based on the various statistics I could find I expected my VL to bottom out somewhere in the "OK" range at 6 months and my CD4 to remain in the good range, leaving me not needing to take meds until some point 5-10 years in the future. Soounded good to me so I delayed.

Nearly one year later my VL has not dipped below 184,000 so it looks like I will be starting meds soon. Hindsight being 20/20 I could say I should have started last year; however, if my VL were to be lower today I would definitely be glad I didn't.

In the end there is no definitive answer to your question. After my research I decided to take a more cautious view towards starting treatment and chose to delay. Other people I know started treatment immediately. Nobody but the individual can say either is right or wrong. I am not pleased with my current VL but I am satisfied that I made an informed decision.

Here's 2 pages I used to help me decide:
http://www.aidsmeds.com/articles/WhenToStart_4757.shtml
http://www.aidsmeds.com/articles/WhenToStart_4758.shtml

Good luck,
Scott

[bradmeistr]

Poly2,
I waited for about two years before I started taking meds.  My doc said that it was best if I started taking meds right away.  I did as much reading as I could and did not find overwhelming evidence that starting meds, right after diagnosis, was the best course of action long term. 

In hindsight I am glad I waited the two years, the meds have not been as side effect free as I had hoped, and remembering to take them so that you don't become drug resistant is also not always easy or stress free.

As the the second poster said, I think this decision is different for everyone.  One friend of my started meds right away as the stress of watching his CD4 count go down was too much for him.  He is glad he started early.  One firend was able to wait almost 13 years before going on meds. 

If you decide to start meds now, definitely read through all the drug literature about dosing (the number of pills and how often), side effects (don't be too scared, as really back reactions are not the norm) and figure out which drugs (along with any potential side effects) would best fit for your life style.

As for me, I started meds at about a CD4 count of around 300 (I really don't remember the actual count).  I wanted to wait as long as possible to start taking the meds.  I told myself that after the first opportunistic I would start my meds and that is what I did (I'll spare you the details of that one - LOL).  I started on Sustiva and Truvada as i wanted to hold off on the Protease Inhibitors (PIs) as I had fears of lipodystrophy.  I here Reyataz is one the better tolerated PIs.  Long story short, I switched from Sustiva to Viramune due to the sustiva side effects and that was the best decision I had made in a long time.  My point is - whatever you decide to do, but when you first start taking meds, remember that with all the different drugs that are out there, you should be able to find ones that have very little if no side effects and should allow you to lead a very productive and happy life.

Keep us posted on what you do.

Brad

[poly2]

Thanks for the replies.  I decided to start treatment now and have been on meds for about 2 weeks.  I felt relieved after I made the choice, so I think it was the right one for me.  I had a rash for about 3 days which made me question the choice, but it has passed.  I'll post again and let you know how things go. 

[milker]

poly2 have you been made aware of adherence issues and that this is currently a treatment for life. I am all for early treatment as long as there is serious "training" about adherence.

Please keep us informed about your progress, it's very interesting to see how meds work on people that take it early. I hope it works well for you

Milker.