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Ask the Experts about AIDS-Related Cancers
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KS TREATMENT
Jan 1, 2004

mY VIRAL LOAD HAS BEEN NO DETECTABELFOR A WHILE & MY CD4 COUNT HASN'T BEEN ABOVE 60 FOR THE PAST 18 MONTHS & HOVERS AROUND 38. LAST YEAR @ THIS TIME I WAS TOLD I HAVE GASTRIC KS. MY ONOCOGIST DOESN'T WANT TO TREAT ME UNTIL MY CD4 IS. THE KS IS CURRENTLY NOT GROWING OR SHRINKING SHOULD I BEGIN TREATMENT? ALL THE INFO I HAVE FOUND HAS EVRYONE HAS 100-250 CD4 COUNTS BUT THERE VIRAL LOADS ARE HIGH AS WELL.

PLEASE GIVE ME SOME GUIDEANCE AS I WILL SEE MY ONCOCOLGIST AGIAN IN JANUARY.

HE IS AFRAID OF CREATING OTHER MEDICAL PROBLEMS FOR ME IF TREATMENT IS STARTED.

IAM ON CURRENT THERAPIES & SEEING MY REGULAR MD ON A REGULAR BASIS.

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   Response from Dr. Pierone

Since the KS is not changing it seems sensible to sit tight and hold off on chemotherapy. Even though your CD4 count is low it should eventually rise as long as your viral load remains undetectable. The hope and expectation is that as your CD4 count increases this will bring the KS under control without the need for chemotherapy. The fact that the KS hasn't changed in a year despite low counts suggests a Mexican standoff" between the KS and your immune system. As your immune system reconstitutes the KS should lose. Let us know how it goes and good luck!


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