What Should You Do?

Some research recommends earlier HIV treatment and other research suggests waiting to start therapy. Which is right for you? Both options are worthy of consideration and supported by scientific evidence. Only you and your healthcare provider can make the right decision for you. Here are some steps that you and your healthcare provider should take to help make the right choice:

• Simple blood test—This test is the first step and gives information about the current health of your immune system. For more information, check out Monitoring Treatment
• Ask questions—you should develop a list of questions to discuss with your healthcare provider, such as side effects, the benefits of early versus later treatment, and how treatment may affect your life

The Jury Is Out

In general, if your CD4 cell count is below 200, you should start anti-HIV treatment. Otherwise, when to start treatment is still a subject of great debate among HIV treatment experts. There are a number of factors that make it difficult for experts to come to agreement on this subject:

• Improving health—some scientific research indicates that early treatment can greatly improve a patient's health and can help in prolonging life
• Side effects—while treatment can greatly improve a patient's health and quality of life, there are a number of side effects associated with HIV treatment. These side effects may cause a patient and healthcare provider, at first, to delay starting treatment if the side effects outweigh the benefits of treatment
• Treatment can become ineffective—over time, HIV can change, a process called viral resistance. This change in HIV can make the drug ineffective in treating your HIV infection and make it necessary to change your medications. Some experts believe that by starting treatment later, you can postpone this need to change medications

If I Choose to Wait...

If you and your healthcare provider do decide to delay starting treatment, when exactly should you start HIV therapy? Again, there is no real agreement about the answer to this question. Some experts believe that you should start HIV treatment when your CD4 cell count is low, below 300, and your viral load is high, 30,000 to 55,000. Other experts believe that you should wait until symptoms of HIV disease are present. However, there is 1 point of agreement among all experts: the decision to treat HIV should be based on overall general health in combination with your CD4 cell count and viral load. For more information on CD4 cell count and viral load, check out Monitoring Your Treatment