you might think that, with such a dangerous disease, you should start to treat it right away. But that’s not necessarily the case. HIV progresses very slowly. It can take as long as 10 years to progress to Aids without treatment.
Once you start taking medications, you have to take them for life. These are powerful drugs and even the very best of them have some side-effects. So you don’t want to start taking them too soon. Obviously, you also don’t want to start taking them too late.
Expert advice on when you should start treatment has always been based on your “T-cell” count, rather than the length of time you’ve been infected.
Your T-cells-called “CD4 T-cells” in full-are immune system cells that are attacked and killed off by HIV. So a declining T-cell count is one of the most reliable signs of advancing HIV. The other barometer doctors use is an increasing “viral load.”
When your T-cells drop below 200 cells/mm3 or when you have an ‘opportunistic infection’ you are considered to have Aids.
Until recently, HIV treatment guidelines suggested that you should wait to start HIV treatment until your T-cell count dropped below 350 cells/mm3.
However, at the most recent Panel on Antiretroviral Guidelines for Adults and Adolescents convened by the Department of Health and Human Services, 55% of the experts strongly recommended starting treatment when your T-cell count drops to 500 cells/mm3.
In fact, 50% of the experts recommended starting even earlier-when your T-cell count is still above 500.
The reason for the change? Today’s HIV medications are much less toxic and much easier on your body. So most doctors now believe the benefits of starting medications early outweigh the dangers.
How do you know when your T-cells start dropping? You should be seeing an HIV doctor and having your T-cell count tested regularly, even if you are not on medications yet and even if you are feeling great.
If you are HIV-positive, of course, the first thing you should do is deal with it. Find a doctor who is experienced in dealing with HIV. HIV treatment is very complex and it changes all the time. Make sure your doctor is an HIV specialist!
Even if you’re not on HIV medications yet, you need a doctor right now to monitor your viral load and T-cell count. Even though you may be feeling fine, you should have your viral load tested every three to four months and your T-cell count measured every three to six months.
When you go on medication, make sure you take them faithfully! Today’s HIV medicines are much easier to take and much more tolerable than the medications available just a few years ago. But they don’t work unless you take them! Missing doses can result in drug resistance. So be sure to take your meds on time, every time.
(to be continued)