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HIV Diagnosis Calls for Immediate Treatment
Caprice_WebMD_Staff posted:
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An_261503 responded:
if this is the case, how come patients are still advised to delay taking anti-hiv drugs until the cd4 count drops below 350? i live in nigeria by the way.
shaunw84 replied to An_261503's response:
Thanks for posting this.
Yes, there is a mounting amount of evidence that suggests everyone should start ARVs.

Unfortunately, the medical community in the US seems to be resistant. Many of them are ignorant of the multifacated benefits of early treatment. Many are holding on to "out-of-date" thinking, because they are simply following old guidelines and not understanding that the rational for the old guidelines have changed.

The principal reason for delaying until CD4 count dropped was the HIV drugs back then were highly toxic and many were not very effective. The thinking was that by delaying start of treatment, the patient would be spared this regime, until it became truly necessary. So instead of understanding the rational for this being understood, the only thing the medical community has held on to is the recommendation: delay ARVs.

But this is no longer true. HIV drugs are far less toxic and far more effective. But the US physician doesn't want to come on board with this shift in thinking.

What many doctors don't understand is that research is also showing that some patient -- the French believe as many as 15% -- if they start ARVs very early, may be able to get off ARVs entirely after a few years. This is because the immune system remains strong in these early medicated individuals After the virus has been reduced using ARVs, the body of some people can fend it off without medications.

There is also the transmission benefit. People on ARVs are less likely to transmit HIV then those who are not on therapy.

The other big hinderance besides the US physician is cost. In the US HIV drugs are 10 - 15 times the cost of what they are in other countries. And what's worst is that the FDA isn't helping.
They are actually taking the side of big pharma trying to prevent the poor from getting access to these cheaper sources by blocking the ability of pharmacies from buying drugs manufactured overseas. Even when, the company that sells the drug at US prices buys the drugs from the same foreign manufacture.

And this is a general problem that goes beyond HIV/AIDs.

If people want the best medical care, they are going to have to educate themselves and use sites like this one.

Be well,

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