Author Topic: Can I start to treatment earlier even mycd4/viral load is fine? (Read 11922 times)

Victor09 · « **on:** July 08, 2009, 04:02:21 pm »

Dear.All - I new here, would like to have some idea or recommend from you around

Mar09--I tested poz I still don't believe until now, but it's fact. I just starting to learn that How can I survive and long live ?

Jul09-- I had blood work result and my cd4 is = 712 and viral load = 2944

I will have (1st app with Dr on coming 21Jul09) However I have read many article about hiv+ I can start treatment even my cd4 count / viral load is? but I called to talk with Nurse, She said that your result is fine no need to start medicine and have to wait next 3 month for blood check again

I afraid of Dr will not start me on therapy! but Hiv+ is in my life and I believe in earlier treatment as soon as someone is diagnosed.

what's your idea?

Victor09

webontheweb · « **Reply #1 on:** July 08, 2009, 04:40:53 pm »

Victor,
Relax you are going to be just fine. Breathe deeply. We all started out just as scared or even more scard than you/ A CD4 of 712 is incredible, a very low viral load is even better. You do not have to start meds. I know that it must sound crazy right now, but listen to your doctors, read up on this site and find a poz buddy or mentor to help guide you through your first year. It IS a big adjustment, but you will be fine.

Ask questions. no question is dumb or inappropriate, you need to educate yourself and we are here to help you.

Cheers to a very long life ahead!

Miss Philicia · « **Reply #2 on:** July 08, 2009, 05:15:45 pm »

Yeah, one of my best friends has been positive with similar numbers for about 12 years and has still never gone on medication, and he's very healthy and active, etc. Just make sure you stick to regular monitoring/lab work.

Victor09 · « **Reply #3 on:** July 08, 2009, 07:07:16 pm »

Thank for above advise from my new friends
Yeah I feel that Here is like a my Home and I have my good friend to talk with

Inchlingblue · « **Reply #4 on:** July 09, 2009, 02:55:39 am »

The biggest unanswered question in HIV treatment guidelines is: when is the optimal time to start meds?

There are studies looking at the benefits of starting very early, within the first year of infection, to see if there are real benefits to this. Back when the meds were so much more toxic it was more of a concern to start too early. The current meds are still hard meds, despite the improvement so it really becomes a question of: how much damage is HIV doing v. whatever damage the meds might do. It's a tough call

The important thing is you definitely do not need to rush into it. If I were you I would research it and then decide. One of the advantages to starting very early, within the first year, is that the size of the HIV reservoirs in the body are significantly smaller, which may help as far as future treatments aimed at eradication.

I repeat: it's a tough call, deciding when to start. Also, depending on where you live and the insurance guidelines some countries with universal coverage won't cover the meds until the numbers are at a certain level.

Victor09 · « **Reply #5 on:** July 09, 2009, 10:39:37 am »

Inchlingblue , Thank for open my eye, However I am going to see Dr soon and I will post for her's
opinion

madbrain · « **Reply #6 on:** July 09, 2009, 12:35:21 pm »

Victor,

Quote from: Victor09 on July 08, 2009, 04:02:21 pm

Dear.All - I new here, would like to have some idea or recommend from you around

Mar09--I tested poz I still don't believe until now, but it's fact. I just starting to learn that How can I survive and long live ?

Jul09-- I had blood work result and my cd4 is = 712 and viral load = 2944

I will have (1st app with Dr on coming 21Jul09) However I have read many article about hiv+ I can start treatment even my cd4 count / viral load is? but I called to talk with Nurse, She said that your result is fine no need to start medicine and have to wait next 3 month for blood check again

I afraid of Dr will not start me on therapy! but Hiv+ is in my life and I believe in earlier treatment as soon as someone is diagnosed.

what's your idea?

Victor09

Sorry to hear you tested poz. But these are good lab numbers. I had very similar ones when I tested originally almost 3 years ago, and I'm still not on therapy.

With your labs, there is no urgency for you to be on therapy, as others have already pointed out. So don't blame your doc if he is not putting you on meds right away.

There haven't been studies in people with numbers like ours starting therapy early, simply because there are not a lot of us. Most people have lower numbers by the time they get diagnosed HIV+. Some because their HIV progresses fast, and some because they don't get tested often enough. So it's hard to know the benefit of the meds.

I know this is a really difficult time right now - but try to get through it and not make hasty decisions. Once you start on HAART it is generally not recommended to stop. You must be sure you can be committed to taking them every day - the side effects can vary. Studies have shown that the majority of people who stop meds get worse. It may be better not to start if you don't need them. That's the path I am on right now.

It will be easier for you to decide what to do after you get a few more lab numbers. It's best not to rely on a single lab value. See the direction they are going. If they stay pretty much the same as mine have, then you and your doc have the luxury to wait for therapy. If they get worse quickly then you may want to be on meds.

Nana · « **Reply #7 on:** July 10, 2009, 09:44:43 am »

webontheweb...thanx, your advice for victor has also helped me. I'm new here & its a year now since i tested +. My CD4 was 1258 on 01/09/2008 & i should have gone for another after 6 months, its 10 months now i never went. i'm just scared & i don't know why, maybe i think it has gone down.

Please help

webontheweb · « **Reply #8 on:** July 11, 2009, 07:16:40 am »

hey nana, Knowledge is power. You no longer have the option on sticking your head in the sand. channel your inner TOWANDA! I am in much better shape and more aware of my body now then I was before I was diagnosed.
I have had more shots and been tested for EVERYTHING and all is good, my doctor told me just yesterday that of all of his patients, I have the most normal blood work and diet regimen. SO, go to your doctor- stay on top of things.
It is better to know than to not know.

I expect to hear back from you! email me personally.
Cheers!

Victor09 · « **Reply #9 on:** July 21, 2009, 12:00:42 pm »

Jul09-- I had blood work result and my cd4 is = 712 and viral load = 2944

*************************************************************************
Jul21- I just came back from 1st appointment with Dr, She said that based on my lab work is fine no need to start on med and ask me to go to blood work another 3 month and will get discuss again
However she ask me to increase immune system by taking multi vitamin and keep exercises and get good food try to reduce my cholesterol to be normal , she don't want to have a kind of problem , she also sent me to vaccine and get ready to start med if my next blood work is go down

So I may ask my friend here, How can I keep my immune system well? what should I do?

Victor

Victor09 · « **Reply #10 on:** July 21, 2009, 12:03:12 pm »

How can we keep immune system well?

madbrain · « **Reply #11 on:** July 21, 2009, 04:08:40 pm »

Quote from: Victor09 on July 21, 2009, 12:03:12 pm

How can we keep immune system well?

One of the important things to do is limit stress. The more stress you have, the worse your immune system is likely to be.

Some moderate but regular amount of exercise will help with your immune system, and will lower stress too.

Diet is also quite important. Watch what you eat. Some foods are better for your immune system than others . In particular, avoid drugs, alcohol, smoking as much as you can.

I also choose to use many dietary supplements, though there isn't widespread agreement that all of them are useful, beyond a multi-vitamin.

Victor09 · « **Reply #12 on:** July 21, 2009, 06:05:20 pm »

Diet is also quite important. Watch what you eat. Some foods are better for your immune system than others . In particular, avoid drugs, alcohol, smoking as much as you can.

I also choose to use many dietary supplements, though there isn't widespread agreement that all of them are useful, beyond a multivitamins.

[/quote]

Madbrain, I have not into drugs ,smoking and veryyyyy few with alcohol
So What's kind of dietary supplements that you take regularly, Can you give me some idea expect
multivitamins?
At this stage I very concern with my immune system so much

Victor

madbrain · « **Reply #13 on:** July 21, 2009, 06:44:54 pm »

Quote from: Victor09 on July 21, 2009, 06:05:20 pm

Madbrain, I have not into drugs ,smoking and veryyyyy few with alcohol
So What's kind of dietary supplements that you take regularly, Can you give me some idea expect
multivitamins?
At this stage I very concern with my immune system so much

My list of supplements is over there : http://forums.poz.com/index.php?topic=26331.msg329451#msg329451

As you can see, it's a lot of pills . And not everyone agrees on their benefits. The one that's fairly uncontroversial is to take a multivitamin. If you want to start any of the others, make sure to check for interactions with any meds you are taking, in particular if you start HAART medication. Your doc/pharmacist can help with that.

Victor09 · « **Reply #14 on:** July 21, 2009, 07:18:57 pm »

Thank you so much

Inchlingblue · « **Reply #15 on:** July 22, 2009, 02:41:46 am »

I would also highly recommend probiotics.

More info. in this post on another thread:

http://forums.poz.com/index.php?topic=27955.msg345903#msg345903

mecch · « **Reply #16 on:** July 22, 2009, 06:06:44 am »

What country to you live in?
Many countries follow the US based treatment protocal, based on years and years of research on thousands of people and also doctors and scientists discussions. According to that, you don't "need" treatment.

So talk to your doctor about your wanting treatment immediately and see how he/she explains your options.

You would have to be prepared to commit to HAART for the long term if you started.
There could be side effects.
Someone has to pay for the HAART and if its insurance you need to meet a protocal, or if not, have a "clever" doctor.

On the other hand, you dont mention your sex life, love life, but there are some advantages to being on HAART and undetectable in these areas. So maybe that is an issue and you can talk to your doctor about it.

Victor09 · « **Reply #17 on:** July 22, 2009, 10:03:03 am »

Thank you

Inchlingblue and
Mecch It's very useful to me and My origin is Southeast asia and now I live in CT
I have to keep track my blood work for 2(on next Oct09) or 3 times and will discuss with Dr again
She said that the cd4 is not rapidly quickly .

Pammypoo · « **Reply #18 on:** July 23, 2009, 11:10:56 am »

I am going to jump in here, I was tested poz 7/2/09, I just went to see my ID doc on 7/21, my CD4 was around 910, and VL was 3800. My doc told me that the CDC doesn't recommend starting treatment because my numbers were so good, but she believes and I agreed with her that we should start. My thought is why wait until the numbers get really bad, why not start fighting this now. She told me that years ago the problem was that you could become immune to the meds and there wasn't as many options back then, she said now there are so many different kinds of meds and with today's advances that that would not be a problem. Now after reading here I am questioning my decision somewhat. Being so new to this maybe I should have researched options more before agreeing with her. I am starting on Atripla tonight for the first time.
Good luck to you, just keep what your doing asking questions and doing research to find the right answer for you.

Ann · « **Reply #19 on:** July 23, 2009, 11:29:05 am »

Pam, if you're questioning your decision to start, you can still wait. Just because you're already in possession of the meds doesn't mean you have to use them. With your numbers, you do have the luxury of time in which to become more knowledgeable. Once you start, you're stuck with your decision. It's better to start when you're SURE it's the right time for you.

Ann

Pammypoo · « **Reply #20 on:** July 23, 2009, 11:54:19 am »

Now I am so confused. When talking to the dr. I was like yes yes yes I want to start the meds, I want to be better! Now after seeing people with numbers so low they have gone months and longer without starting treatment. I mean I have read the pro's and con's and I just really dont know what to do now. I have never been good with making decisions and trusted people to much to make decisions for me, so I really want to do the right thing here and make my own educated decision.
Thank you Ann I am going to think on this!

Victor09 · « **Reply #21 on:** July 23, 2009, 12:17:53 pm »

Pam, you have the same case with me, I am very confused on my therapy! based on our CD4 and VL is look good. My Dr. still keep me waiting to in to med. and explained that the CD4 is not rapidly change quickly. Let me do exercises and keep immune system great and will look to see blood work for another 2nd on Oct09
I understand your point. Now Hiv+ in our body even they small but I want to freeze them or stop it by taking med

Victor

alberche · « **Reply #22 on:** July 23, 2009, 04:10:11 pm »

Dear all,

The most important is that with good lab numbers you have time to be informed and then choose.

I started meds 2 months after getting infected. In my case, I knew when I got the virus. My doctor directly proposed me to start and I accepted. That was 3 years ago. I started with 1120 CD4 and aVL of 60.000 (my VL at diagnosis was of 264.000).

Now I've been undetectable during these years so far and always above 1200-1600 CD4 (1948 CD4 in last labs)

Now I am visiting my doc and getting labs twice a year, every 6 months.

I am on Truvada+Reyataz+Norvir. No major problems. Only some digestive concerns during the first weeks and skin more prone to get dry in winter and summer, nothing that could not be solved with a moisturizing cream. Also had during the first year some pain in joints (at lower back), but now it is completely gone.

No cholesterol concerns, no sugar, all blood parameters are normal. I started going to the gym consistently, and changed my diet to a mediterranean one, including fresh fruits and vegetables, less meat and more fish and chicken.

My partner is negative, we use condoms, and have had no problems at all, our sex life is as good as it was before. He is also much better emotionally since he sees I am well and confident.

I think for me it would have been more difficult to "wait and see", I feel better with the idea of that, taking treatment and careing myself I am active against my infection. It is my personal feeling as per regards to myself.

In my case I am happy with my choice. But I agree that everyone must take the time to think about her/his circumstances, and then decide.

In my opinion, meds now are easier to take and have lesser side effects, for most of people, as in my case, side effects are not noticiable or not a big problem to deal with. So, I think we should not defer treatment starting only based on the fear to treatment and its effects.

The decision should be made fundamentally under the premise of having good and sufficient information as to have our main doubts clarified, and also, of being conscious of that, once started, treatment will be, as far as we know, a lifeime question.

Once you start, you will have to keep on your meds probably for the rest of your life. Adherence (being consistent and compliant taking meds) is a key issue for treatment success.

It is not so difficult to be adherent, so no place to fears in this way, but it needs discipline and the ability to maintain an organized daily routine. It is worth to think on this before deciding to start.

And, a golden rule: ask for help, ask for information, talk to others, the most you know, the better you will be living with HIV.

Big hugs :-)

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Author Topic: Can I start to treatment earlier even mycd4/viral load is fine? (Read 11922 times)