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Pros and Cons of Starting Treatment Early

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R2J  -  I started very early, within three months of seroconversion (we think).

Over the last ten years my numbers have been consistently very good. 

HOWEVER, and this is a big caution, I would recommend you read up on this issue and solicit advice from many people.  It is YOUR DECISION, YOUR LIFE.  You have to do what you feel is best. 

I wish I had someone to talk me out of taking meds early.  I was hell bent on doing so, terrified and afraid, and I HAD TO DO SOMETHING.  My personality does not permit me to find it easy to sit idly, being patient, hoping that things will be OK.  If I know about a problem, I tend to want to solve it.   That's not always so good.

I have had to change meds several times until i landed on my current combo five years ago.  (six almost)
The side effects were horrible:

AZT:  projectile public vomiting.  severe anemia.
D4T:  peripheral neuropathy
Crix:  kidney stones (oo baby), lipodystrophy
Sustiva:  severe anxiety, depression and insomnia.  believe it or not, that was the worst one for me.
Viramune:  severe acid reflux, which I can control with other drugs.

Also included have been elevated cholesterol levels, which may or may not be related, and almost hypoglycemia, which my doc is convinced is caused by Abacavir.  However, I don't know of anything which proves him right except his own experience.

At any rate, meds can and do save people's lives.  They are not to be taken lightly.  And, please do not start them just because you might have similar personality characteristics as I do.  Step back and listen to all the points of view and keep an open mind.

Cheers.  And, I wish you the very best,


Hi r2j and welcome to the forum,

Like yourself I am a newly diagnosed 26 yo and I am in the same confusion about when to start meds, and after talking to my doctor, I have to agree with Ann for several reasons :

-Before there was no advanced tests like viral load and CD4 levels so people would find themselves with OI(opportunistic infections) so now monitoring your health is an option
-If you're still in the seroconversion phase, I would have encouraged you to start meds because they say that during this phase the virus causes the most of damage but i Guess you missed that phase so....
-the theory of "hit hard hit early" is like they say a theory and there is much questioning about it.
-you have to be READY for the meds because adherence is the MOST important issue in taking them, missing one dose each week could lead to lots of trouble.
-the meds can have short and long term side effects, we're forgetting also the resistance and the fact of taking meds EVERYDAY for the rest of your life.

So I decided to wait a little bit to check with my numbers few month later and given that your CD4 is average+ I think you should wait a little bit.

Since you are newly diagnosed like me, I understand the pain and frustration you are facing so hang in there and be strong because now its too late you have the "VIRUS" try to think what is best for you now even though all im doing lately is watching dvds all day long but im hanging in there and I will fight this "disease of the century" because i love life too much to die while im still breathing.

Good luck and be strong.

Hey RJ,

What is your current CD4 count and CD%?   

The 715 was great, but as the others said it might be worth waiting for several labs.   I'm now going on a year without meds, but so far my numbers have slowly declined although I'm not at all sick or anything.

There are very convincing arguements for delaying and starting treatment early.   I've spent the last year asking this question and haven't found anything conclusive either way, but have now decided that if my labs have dropped further I will be starting meds soon.

Some of the more recent articles seem to lean towards earlier treatment, but it's really gona come down to your choice.   You can see my numbers below for comparison if that helps you at all.   

Your numbers are better than mine  : )   High CD4 is good, but probably with more info. you will get some other opinions and there are some excellent folks here to share their stories.

I'd wait to see what happens over the next couple months.  How often are you having labs done right now?

Holler at me if I can be of any help.   


Hello rj,

The following link ( from the lessons on this site), may help to give you a better understanding of things.

 Your numbers are good, and it could be quite a while before you start treatment.

Ask questions if there are things you don't understand from the link I just gave you, But take your time reading it.

Take care-Ray

Hey everyone. Thanks for all the advice. I've been doing a lot of thinking about this obviously over the past week. I haven't made a decision yet but I think that the fact that I haven't decided means I'm not starting... but I'm still not 100% sure. I feel like I'm out of the acute/primary stages of infection where the most benefit is said to occur when starting treatment. I also don't know if I'm prepared to deal with the side effects when its not 100% certain to be worth it.

Since my diagnosis, I've made a lot of other changes in my life which have made me happy and continue to help me keep a positive outlook. I'm relying on those changes to make it "feel" as if I'm doing something to treat the disease.

Thanks for your help! I really enjoy reading all the forums and hope to post more :)


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