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Author Topic: Recently diagnosed, should I start treatment by default?  (Read 1582 times)

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Offline new_2013

  • Member
  • Posts: 10
Recently diagnosed, should I start treatment by default?
« on: March 07, 2013, 03:12:43 PM »
Hi all,
    I expect this question has been asked numerous times but suppose I just want a personal response, if that makes sense.

I was diagnosed in January 2013 and have got 2 blood results so far
10th Jan 2013 - CD4 = 507, CD4% = 19%, VL 1669
24th Jan 3013 - CD4 = 482, CD4% = 21%, did not take VL count

My next test will be 27th April to give a 3 month span between initial results.

I am reading a lot regarding recent advice that if you are diagnosed with HIV then you should go on meds straight away, why avoid what will ultimately be required anyway?

In my last visit to the doctor I asked should i go on meds regardless of my counts and she said there is no straight answer but the meds have impact on the body also and if the body can maintain health CD and VL it is probably best to defer the meds until they drop to recommended guidelines.

I am currently feeling generally fine and assuming no issues with compliance, side effects, safe sex etc I would appreciate some feedback on should i pust for meds on my next visit or continue with UK based recommendations (which would be 350 CD count to start meds).

Thanks in advance,
Mark

Offline mecch

  • Member
  • Posts: 11,484
  • red pill? or blue pill?
Re: Recently diagnosed, should I start treatment by default?
« Reply #1 on: March 07, 2013, 03:53:06 PM »
Welcome here.
What have you learned, or what do you feel, are the advantages/disadvantages of starting now?

And vice versa, what do you feel are the advantages/disadvantages of waiting....
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline new_2013

  • Member
  • Posts: 10
Re: Recently diagnosed, should I start treatment by default?
« Reply #2 on: March 07, 2013, 05:12:56 PM »
Hi, thanks for welcome and reply.

I am just asking the question purely from a health/medical perspective, not lifestyle. There is an overwhelming volume of information on the internet and I am looking to hear other personal choices to help form my own. 

Taking lifestyle/mental advantages/disadvantages out of the equation (obviously they will factor into the decision making process), what should I do based on the most recent medical references?

I suppose I am thinking if I hear some personal stories and decisions that people have made based on similar blood counts as my own it will assist in helping me make mine.

Mark

Offline buginme2

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  • Posts: 2,834
Re: Recently diagnosed, should I start treatment by default?
« Reply #3 on: March 07, 2013, 05:25:09 PM »
If you're just asking opinions then, my opinion is to start as early as possible.

There is a plethora of medical news over the past few years each pointing to starting earlier.  Rarely if ever is the advice from the medical community to delay treatment.


Offline Pricho01

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  • Posts: 58
Re: Recently diagnosed, should I start treatment by default?
« Reply #4 on: March 07, 2013, 07:16:21 PM »
I definitely wish that I had started earlier...purely from the fatigue side of things... I'm 8 years in.

All the best.

P
Dear Optimist, Pessimist, and Realist, While you guys were busy arguing about the glass of water, I drank it! Sincerely, The Opportunist

Offline Larsen

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  • Posts: 41
Re: Recently diagnosed, should I start treatment by default?
« Reply #5 on: March 08, 2013, 03:57:15 AM »
For what it is worth, I agree with buginme2 and Pricho01.

I started treatment very early and have never had a moment of regret.

My reading of the research is that, with the treatments now available, the benefits of starting treatment as soon as circumstances allow, by far outweigh the disadvantages .. and probably make the process of starting treatment much less stressful. Doubly so if you are one of the substantial minority who turn out to be a discordant responder and are likely to grow  frustrated with a sluggish response in your numbers.

I rarely come across anyone who, having started treatment in the last few years, wishes they had started later; but I come across many people who wish they had started earlier.

But that is a purely personal opinion.
In a far better p[lace than this minging shithole

Offline Larsen

  • Member
  • Posts: 41
Re: Recently diagnosed, should I start treatment by default?
« Reply #6 on: March 08, 2013, 04:59:00 AM »
Suggested reading: Introduction to combination therapy covers many of the things you are doubtless asking, including the big 'deciding when to start treatment' question. You can read it online, download it or send off for a free print copy.
In a far better p[lace than this minging shithole

Offline mecch

  • Member
  • Posts: 11,484
  • red pill? or blue pill?
Re: Recently diagnosed, should I start treatment by default?
« Reply #7 on: March 08, 2013, 07:29:35 AM »
I am just asking the question purely from a health/medical perspective, not lifestyle. There is an overwhelming volume of information on the internet and I am looking to hear other personal choices to help form my own. 

Taking lifestyle/mental advantages/disadvantages out of the equation (obviously they will factor into the decision making process), what should I do based on the most recent medical references?

But the decision is made considering all factors and living breathing people in this forum made decisions based on all these factors bearing on our individual lives.

Starting early offered me mental and lifestyle advantages. 

Medically, starting a few months after infection was biologically necessary for me - so my situation is not the same as yours.  I wish it had been during seroconversion, in retrospect. So, sooner.

Ok then, sticking JUST to medical - do you know how long you have had HIV.  WHen was the last HIV- test. When do you suspect or know you were infected....   (If its 5 years ago, or 10 years ago, debating the medical benefits of starting now or in another two years is a different debate then if infection was 3 months ago.)





“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline new_2013

  • Member
  • Posts: 10
Re: Recently diagnosed, should I start treatment by default?
« Reply #8 on: March 08, 2013, 12:44:44 PM »
Hi, thanks for taking the time to respond guys.

Mecch, I tested negative Feb 2012 and the only time I was sick was in May so I expect that was my seroconversion.

Larsen, thanks for your response and info link.

buginme2 and Pricho01, thanks also for your opinions.

Offline newt

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  • Posts: 3,878
  • the one and original newt
Re: Recently diagnosed, should I start treatment by default?
« Reply #9 on: March 08, 2013, 03:42:48 PM »
There is no serious evidence that treatment at CD4 counts in normal range, like yours (in studies 500+ but yours is within normal range). there is evidence which suggests this may be a good idea, and the US guidelines went for this recommendation, but note it's an expert recommendation not one strongly supported by data. HIV treatment is a history of right and wrong expert recommendations. Mostly wrong. I tend to go with the data.

At your CD4 count, your risk of serious illness or death is a fraction of a percent higher than a person without HIV of same age.

There is some evidence that treatment in the first phase of HIV (called primary HIV infection) is a good thing, because it helps your immune system respond better to the presence of HIV, but this means 6 months or sooner from getting the bug.

And, important, treatment will knock your viral load on the head and seriously reduce, if not quite (but nearly) eliminate, the risk of onward transmission.

The thing with med is, once you start it is recommended you don't stop.

It is a fair call to start or wait.

Hope this helps.

- matt
"The object is to be a well patient, not a good patient"

Offline Larsen

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  • Posts: 41
Re: Recently diagnosed, should I start treatment by default?
« Reply #10 on: March 09, 2013, 06:23:33 AM »
I dug this out for you. I know you want the personal take, but I think it is a very valid summary of the pros and cons of starting treatment. It is basically some summary notes of the ongoing START trial to find an answer to the current equipoise on when to start treatment: START trial if you were recently diagnosed, with some more recently updated background on the START study which goes into a little more of the background to Newt's very valid points.
In a far better p[lace than this minging shithole

Offline new_2013

  • Member
  • Posts: 10
Re: Recently diagnosed, should I start treatment by default?
« Reply #11 on: March 09, 2013, 05:45:47 PM »
Thanks Matt for your insight, I have seen your posts on other sites and appreciate your depth of knowledge.
Larsen, thanks for the links, very kind to seek out relevant references for me.
It makes a difference to get a personal response to a query so thanks again to all, x

Offline JazJon

  • Member
  • Posts: 94
Re: Recently diagnosed, should I start treatment by default?
« Reply #12 on: May 03, 2013, 05:41:27 AM »
Earlier the better! 
(you don't want to create a wide spread unreachable latent reservoir)

Topic: Early HIV drugs 'functionally cure about 1 in 10
http://forums.poz.com/index.php?topic=47816.0

 


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