I am finding a lot of conflicting information from the doctors, the booklets they provide and of course the medical websites.

I was told that i need to start now, because i have a low cd4 count <200. I have recently read a booklet that they gave me that it is best to start before the count gets below 200 cells/mm3.

I have checked several NHS sites in the UK and they all give conflicting info.

I am not ready to start even if i do have a low count.


What is the starting point in the USA? and is it the same from state to state?

Try the Mayo Clinic's website. I found some great info there for the treatment of Hep-C. Or maybe the Cleveland Clinic's website. Both places are huge research hospitals. The Mayo Clinic's website will also allow you to ask medical professionals questions for free.

Trucker Mark

if your cd4 is under 200, technically you have AIDS. it is dangerous and absurd for you to be not on meds at this point. i was on meds long before they dipped below 200. i decided to start when after a year of steady cd4 drop. my doc and i talked it out together and decided to start them. i am amazed that you are not on them yet and feel that your fear of taking them will end up killing you. or maybe you are okay with that? but i can tell you, that being in the hospital with any opertunistic infection (that you are very susceptable to) is not fun. it was way worse than taking daily pills.

ultimately you need to talk to your doc. here, there isn't a mandated starting point because each person is different. but you and your doc need to come up with a strategy on how to go about treating it. if you don't trust your doc, find a new one. that relationship is really important.

what exactly scares you about starting meds?

Jarrad,

In the UK things are done differently. We are not diagnosed with AIDS until an opportunistic infection is diagnosed in my case i have none at all - which does surprise them.

I will not take the medication i do not believe that i need it at all. Yes, there are the issues of side effects which i am not happy with like high cholesterol levels which of course can be controlled on a proper diet which i have. My cholesterol levels are really low at the moment.

then there are the issues of liver/kidney disruption etc.......a few months back i had a very bad rash on my legs i walked out into the garden and walked though stinging nettles and after several days of this the rash cleared up, i did not have to use the cream that they had given me.

i did the same thing to both of my arms as well. i have come this far with out medication and i will continue to go on without them. yeah, it may seem a bit absurd but i am willing to take that risk.

My doctor is aware of my decision and they cannot make me take them.

if you are so set on not taking your meds? why are you asking the question? sounds like you don't really care.

i wanted to know if things were done different in the USA regarding the cd4 count that is all.

There are no hard and fast rules, but in Australia, current recommendations are that treatment should be commenced when:

Your CD4 cell count is 350 or below.

AND / OR

You have symptoms of an Aids defining illness.

If you have less than 350 CD4 cells and/or a viral load above 100,000, it is time to seriously consider commencing treatment if you haven’t already begun. It is equally important for you to be "ready" or in the right frame of mind to commence treatment. If you have concerns about starting, discuss all the pros and cons with your doctor, nurse or treatments officer. Once you have taken your first few doses the whole idea becomes far less worrying.

If your doctor recommends treatment, but you decide not to commence, just yet, it’s highly advisable to have regular check-ups, including blood tests, at least every month.

From the Aids Council of NSW

its actually interesting that each country has a differnt set of rules. that's something i didn't know.

aaron brings up a good point with VL being about 100,000. what's yours at duncan?

thats very interesting aaron. my doctors and the rest in the UK dismiss the viral loading and look only at the cd4. In answer to your question Jarrad. I have a viral load of 9,750.

having said that there is some sort of relationship between the two. besides those test they also do a cd8/cd4 ratio test.

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