When should I start treatment?
It remains unclear when the best time to start therapy is. The “best” time for one person may not be the “best” time for another. There’s also much debate about which drugs to start with and in what combinations. Several factors — including HIV levels, CD4+ counts as well as how you feel about therapy — are important to consider when deciding if and when therapy is right for you.
Many questions can also be considered when making these decisions. Should treatment be used immediately when you first learn you have HIV? Should therapy be saved until changes occur in your immune health? Should it be saved until there’s a higher viral load, or until symptoms of HIV develop?
In deciding when to start, switch or change HIV therapy, three medical factors are generally considered:
•What’s happening with measures of your immune health (particularly CD4+ counts)?
•What’s happening with your general health, like symptoms of HIV disease or recurrent conditions despite treatment?
•What’s happening with your HIV levels?
Deciding to begin treatment is not solely a medical matter. Other factors must be considered, including:
•Your feelings about therapy;
•Your readiness and willingness to take therapy, including taking it as prescribed;
•The impact that therapy may have on your quality of life;
•Possible side effects;
•How long therapy can last, and whether or not there will be new and better drugs to replace them if or when they fail; and,
•Your risk of disease progression in the short-, middle-, and long-term.
When is the right time to start?
Some believe there can be no single, right answer to the question of when to start. Some researchers and doctors believe that nearly everyone with HIV — regardless of their CD4+ counts, viral loads or symptoms — should be treated. Some believe people should start therapy only when their CD4+ counts consistently read below 350. Others believe that only people with symptoms of HIV disease should consider therapy.
One note of agreement is that most researchers and doctors believe that the decision to start should be guided by both CD4+ cell counts and overall general health. Increasingly, information suggests that CD4+ counts provide the most accurate tool to monitor the risk of HIV disease progression.
The most commonly used viral load tests are Roche’s RT-PCR (polymerase chain reaction test, called Amplicor HIV Monitor Test), Chiron’s bDNA (branch DNA test, called Quantiplex) and Organon Teknika’s NASBA (nucleic acid sequence based amplification test, called NucliSens). When possible, it’s best to use the same lab and same test every time. For example, RT-PCR results are consistently higher than those obtained with bDNA. Similarly, different labs might get somewhat different results when running a CD4+ count.
It remains unclear when the best time to start therapy is. The “best” time for one person may not be the “best” time for another. There’s also much debate about which drugs to start with and in what combinations. Several factors — including HIV levels, CD4+ counts as well as how you feel about therapy — are important to consider when deciding if and when therapy is right for you.
Many questions can also be considered when making these decisions. Should treatment be used immediately when you first learn you have HIV? Should therapy be saved until changes occur in your immune health? Should it be saved until there’s a higher viral load, or until symptoms of HIV develop?
In deciding when to start, switch or change HIV therapy, three medical factors are generally considered:
•What’s happening with measures of your immune health (particularly CD4+ counts)?
•What’s happening with your general health, like symptoms of HIV disease or recurrent conditions despite treatment?
•What’s happening with your HIV levels?
Deciding to begin treatment is not solely a medical matter. Other factors must be considered, including:
•Your feelings about therapy;
•Your readiness and willingness to take therapy, including taking it as prescribed;
•The impact that therapy may have on your quality of life;
•Possible side effects;
•How long therapy can last, and whether or not there will be new and better drugs to replace them if or when they fail; and,
•Your risk of disease progression in the short-, middle-, and long-term.
When is the right time to start?
Some believe there can be no single, right answer to the question of when to start. Some researchers and doctors believe that nearly everyone with HIV — regardless of their CD4+ counts, viral loads or symptoms — should be treated. Some believe people should start therapy only when their CD4+ counts consistently read below 350. Others believe that only people with symptoms of HIV disease should consider therapy.
One note of agreement is that most researchers and doctors believe that the decision to start should be guided by both CD4+ cell counts and overall general health. Increasingly, information suggests that CD4+ counts provide the most accurate tool to monitor the risk of HIV disease progression.
The most commonly used viral load tests are Roche’s RT-PCR (polymerase chain reaction test, called Amplicor HIV Monitor Test), Chiron’s bDNA (branch DNA test, called Quantiplex) and Organon Teknika’s NASBA (nucleic acid sequence based amplification test, called NucliSens). When possible, it’s best to use the same lab and same test every time. For example, RT-PCR results are consistently higher than those obtained with bDNA. Similarly, different labs might get somewhat different results when running a CD4+ count.
