Question
I’ve just been diagnosed, why has my doctor suggested starting treatment early?
25 May 2012. Related: All topics, Newly diagnosed, Starting treatment.
Hi there – I have just been diagnosed and I am awaiting the results of my CD4/Viral Load. The doctor at the clinic mentioned to me about starting treatment early. I always thought that treatment was started when your CD4 count falls to 350 or below. Is this something new?
Also, I like to do winter sports – will I be able to get travel insurance for my skiing?
Answer
Hello,
I’m sorry to hear about your recent diagnosis.
The question of when to start treatment is very individual. UK guidelines recommend that everybody should start treatment if their CD4 is around 350 or less.
New guidelines also recommend treatment at earlier CD4 counts depending on the individual’s personal situation.
If you are coinfected with Hepatitis B or C you would be recommended to start treatment if your CD4 count was less than 500. Or if you presented with an ‘AIDS defining illness’ (such as Kaposi Sarcoma) you would be recommended to start treatment regardless of your CD4.
An exciting addition to new treatment guidelines also recommend that people with a CD4 count over 350 should be able to start treatment if they are worried about transmitting HIV to partners. This is because of new evidence that shows that effective HIV treatment can reduce sexual transmission by up to 97%.
As I said, deciding when to start treatment is very individual. Our recently updated guide to combination therapy has the answers to many questions you might have about starting treatment.
Finally, there are insurance companies that provide travel insurance to HIV positive people. Please follow this link to a similar question.
Your doc could also ave even referring to the START trial which s looking at the effect of starting treatment at leves above a CD4 count of 500 as opposed to waiting until 350.
Your consultant may feel that you are in the acute infection phase, your initial test result may indicate this. It may have reacted towards the P24 antigen but not to HIV antibodies.
There is some evidence to suggest that starting treatment in the acute infection phase may help preserve important memory cells that could play an import role should a functional cure be found.
If you are concerned make sure you ask the question when you next see your consultant.
Hope everything becomes clearer for you.