Regarding starting medications

[hope4love]

I tested HIV + on 1st Jan 2010 and I was HIV- when I tested in Jan 2009. My Cd4 count is 230 and viral load is 3000 K. Doc in India, Delhi tells that according to my cd4 count I should start the medications but as per viral load I cannot start. He tells if the viral load is 50,000 and if the cd4 is less then 350 he would have started the medications. He asked me to redo the cd4 count in March and then will take the call on starting medications. I would like to know your opinion on this.. and I also feel a lot tired these days is this because of less cd4 count? is their a danger if I start medications later? please let me know.

[Inchlingblue]

CD4 counts are very important when determining when to start meds, but so is viral load as well as length of time of infection.

While some people do progress quickly after infection, most people are able to control HIV without medications for several years.

Looking only at CD4s then yes, you should start. But you do have a relatively recent infection and your viral load is low so these are things to also consider.

What your doctor recommended seems fine, to check again in March and take it from there. It's good to get several lab results and see a trend in the numbers rather than just one reading.

The fatigue could very likely be due to your body fighting this new unwanted "guest." I would make sure to reduce my stress levels as much as possible, eat well, get the proper rest, basically take care of yourself during this time. Live your life as normally as possible but also stay away from potentially infectious situations, such as being in close contact with someone who is sick with something contagious. Make sure to wash your hands. Since your CD4s are on the low end of the spectrum you want to be careful but don't drive yourself crazy either.

Do you know if a resistance test was performed to see what medications are open to you? I know that in some resource-limited settings this is not always done, not sure what your situation is or what the protocol is in your country.

Viraday, which is generic Atripla is manufactured in India so I assume it would be available to you?

[hope4love]

Inchlingblue thank you for the information.

The private doctor prescribed me the drug called Trioday which is tells this as a new drug from the Cipla company better than Atripla. The Govt Doc told to hold on untill March untill the fresh CD4 counts. No drug resistance tests done here in India.

for the past two months I also have small quanity of balck sputum which is worring me. The Doc tells it will go their is no TB and clear chest x rays on investigation. This could be the reason for low cd4 counts too? what could be the reasons for black sputum?

[tednlou2]

When I Googled "black sputum" it talks about everything from respiratory infections, COPD from smoking, and lung problems coal miners get.  Googling something can often help, but also worry you for no reason.  Do you have any breathing problems?  Chest pain?  Black sputum doesn't sound normal to me.  You should definitely follow-up with your doctor about it just to make sure.  Are you a smoker?  Around coal?  Around black dust?

On the feeling tired issue, I was so tired for several months after I was infected.  It felt like a really bad case of mono.  I hope you feel better soon. 

[Ann]

Hope,

Your doctor should be taking a sample of your sputum to find out what is causing it. An x-ray won't tell him that.