Even in these patients, most guidelines more or less urgently recommend starting treatment, although the immediate risk of developing AIDS is still low. In the MACS Cohort, frozen blood samples obtained in the years 1985-1988 were analyzed and correlated with the clinical course of disease in these patients (Phair 2002). Results showed that not a single patient with more than 200 CD4 cells/^l and a viral load below 20,000 copies/ml developed AIDS within the following year. The authors concluded that it is possible to wait in cases of low viral load in such patients. It is nevertheless advisable to consider individual factors in this CD4 cell category. Is the patient willing and able to take therapy? If there are doubts, it is better to wait. How rapid is the CD4 cell decline? If there is no clear trend, it may also be appropriate to wait. See below for results of cohort studies.
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