Please Scroll Down to See Forums Below I was diagnosed with acute HIV infection in november and am already on meds. I've noticed people on this board saying that they'be been positive ten years without taking anything. My doctor believes that starting meds early will lower my viral load set point so that long term better off. I think the plan is to take meds until my HIV is under control and then discontinue. Is this a good plan or what do you guys think/hear? I know there's debate about starting meds early or waiting until your CD4 is around 200-350...thoughts appreciated. Thanks
When to start meds
- Thread starter UMguy
- Start date
ulostinsane
New member
I've also been reciently diagnosed...so i would also like to know what others feel, but from what I have read I'm not thinking early treatment is a great idea. What do others feel?
So far there's been no medical evidence that early treatment provides any benefit. Then again...it's never been proven to hurt either. It does, however, mean that you'll be starting medications earlier, and you may not want to use up the "arsenal" (i.e., classes) of anti-retroviral medications early on. Depending on how good a person is at adhering to their regimen, each class of medication works for a few years and then sometimes has to be replaced (again, that's largely dependent upon an individual's ability to take the meds at the same time EVERY day...with no missed doses).
My own two cents...I think the traditional approach of waiting until one's T-cells are at 350 or below makes more sense. That way you preserve the classes of medications until you really need them. It also helps to avoid all the "co-pays" you have to make under your insurance plan...and anti-retroviral medications are NOT cheap...so I hope you have insurance! Typical costs through a retail pharmacy run anywhere from about $1,500-$2,500 depending on the medications prescribed (assuming you had to pay them yourself at full retail price...insurance companies don't pay that much).
My own two cents...I think the traditional approach of waiting until one's T-cells are at 350 or below makes more sense. That way you preserve the classes of medications until you really need them. It also helps to avoid all the "co-pays" you have to make under your insurance plan...and anti-retroviral medications are NOT cheap...so I hope you have insurance! Typical costs through a retail pharmacy run anywhere from about $1,500-$2,500 depending on the medications prescribed (assuming you had to pay them yourself at full retail price...insurance companies don't pay that much).
nybb10001 said:
I hear ya. My doctor gave me the option of starting early or waiting. She too said that there was no real clear evidence on either side. I do have very good insurance, but still had a scare the other day when the insurance company was a little slow to pay a claim. I got a bill from my doctor for like $1600 for I think one visit to the office. I'm just recently on my own, so I was freaking out thinking I had some kind of deductible to pay and whatnot, but I called the insurance company and they just assured me that things were "processing"...before the call though I had a near nervous breakdown how I was gonna go broke, lose my doctor, etc etc....
Back on point, I think my doctor started early treatment because I don't have any drug resistance and she doesn't want me to get even any minor opportunistic infections because of the psychological damage that can do to someone newly diagnosed. She also explained that with my overall health, lack of treatment resistance, and the new drugs coming out all the time, that it would be a good idea to start early so long as I adhere to my medications,which I have taken without fail at the exact same time everyday. I wouldn't say I'm an obsessive person, but I do have it on my mind throughout the day how close it is, time-wise, to when I need to take my pills. And after about two and half months of treatment I feel completely fine right now....the side effects are gone and I think my next visit to the doctor should show a very low viral load. But if you think you might miss ANY doses, then I'd say wait...I think a study showed that even medical professionals with HIV had the same trouble adherering to their drug routine. 95% adherence is the minimum I believe....which basically means don't miss a dose...or it'll compromise the longterm effectiveness of the treatment.
To see if yoou can stay on meds as you are supposed to, get a pill box with four slots for each day. At the beginning of the week, fill all the slots with a candy such as skittles. Go thru the week eating each one at the proper time. By the end of the week, you should have a good idea of what type of scheduael(sp) you can handle. Thanks! Alan Chiras.
UNITED STATES: "Early Treatment Always Better for HIV, Study Finds"
Reuters (02.07.06):: Maggie Fox
Patients who began highly active antiretroviral therapy earlier suffered less treatment-related toxicity than patients who started HAART later, according to research presented Tuesday at the 13th Conference on Retroviruses and Opportunistic Infections in Denver. The study, carried out by CDC and the University of Colorado Health Sciences Center, is based on the medical records of 2,304 HIV patients involved in a larger 1996-2005 HIV Outpatient Study.
"Earlier was better in almost everything we looked at," said Dr. Kenneth Lichtenstein of the University of Colorado. "If you stayed on treatment and started earlier, you had the best outcomes." Current guidelines that recommend delaying therapy are based on assumptions that earlier treatment worsened toxicities, but Lichtenstein and colleagues found that assumption did not pan out.
Patients are generally told to begin HAART when their CD4 cell count is 200 or below. But some study participants began HAART at cell counts of 350, 500 and higher.
In their analysis, researchers divided patients by CD4 count at initiation of HAART and compared patients' experience of three common treatment side effects. Patients who began HAART with CD4 counts above 350 were at least 60 percent less likely to develop kidney insufficiency, 30 percent less likely to report peripheral neuropathy, and 60 percent less likely to develop lipoatrophy than patients who began HAART when their CD4 counts were 200 or below.
Inflammation appears to be an important factor, said Lichtenstein. "The state of inflammation associated with disease brings up the toxicity." Treatment was most active in and around cells when there were fewer CD4 cells, he added.
In the past, HIV/AIDS patients often took many more pills, had fewer treatment options, and treatment side effects were more severe. Patients were wise to hesitate in starting therapy because, if the virus developed resistance, there were fewer effective drugs to turn to.
Drug companies have simplified regimens so that some patients can take as few as two pills a day. "Now there are four classes of drugs, soon to be five classes," said Lichtenstein. There is no reason to delay HAART, and no reason to delay testing for HIV, he said.
Reuters (02.07.06):: Maggie Fox
Patients who began highly active antiretroviral therapy earlier suffered less treatment-related toxicity than patients who started HAART later, according to research presented Tuesday at the 13th Conference on Retroviruses and Opportunistic Infections in Denver. The study, carried out by CDC and the University of Colorado Health Sciences Center, is based on the medical records of 2,304 HIV patients involved in a larger 1996-2005 HIV Outpatient Study.
"Earlier was better in almost everything we looked at," said Dr. Kenneth Lichtenstein of the University of Colorado. "If you stayed on treatment and started earlier, you had the best outcomes." Current guidelines that recommend delaying therapy are based on assumptions that earlier treatment worsened toxicities, but Lichtenstein and colleagues found that assumption did not pan out.
Patients are generally told to begin HAART when their CD4 cell count is 200 or below. But some study participants began HAART at cell counts of 350, 500 and higher.
In their analysis, researchers divided patients by CD4 count at initiation of HAART and compared patients' experience of three common treatment side effects. Patients who began HAART with CD4 counts above 350 were at least 60 percent less likely to develop kidney insufficiency, 30 percent less likely to report peripheral neuropathy, and 60 percent less likely to develop lipoatrophy than patients who began HAART when their CD4 counts were 200 or below.
Inflammation appears to be an important factor, said Lichtenstein. "The state of inflammation associated with disease brings up the toxicity." Treatment was most active in and around cells when there were fewer CD4 cells, he added.
In the past, HIV/AIDS patients often took many more pills, had fewer treatment options, and treatment side effects were more severe. Patients were wise to hesitate in starting therapy because, if the virus developed resistance, there were fewer effective drugs to turn to.
Drug companies have simplified regimens so that some patients can take as few as two pills a day. "Now there are four classes of drugs, soon to be five classes," said Lichtenstein. There is no reason to delay HAART, and no reason to delay testing for HIV, he said.
Similar threads
