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What are my chances of Hodgkin's recurrence? I'm scared.
Oct 21, 2001

I was diagnosed with Hodgkin's disease Dec 2001. I was also diagnosed as HIV positive the same week as the cancer diagnosis. I went on ABVD chemotherapy, 8 sessions, (Jan 2001- Apr 2001) and started HIV meds at the same time. I continued on HIV meds during chemo, and my HIV viral load became quickly undetectable, and has remained so. The cancer is gone, and I had 20 radiation treatments from June through July to be sure it was gone. My CD4 count is still low, around 120, but the drs say it should rise in time, with the virus being held at bay, and the chemo and radiation effects wearing off. I am now scared of a reccurrence of the Hodgkin's. What is the chance that the Hodgkin's will recur, in the setting of HIV? Do you think my CD4 count will rise, and if so, will this protect me against a recurrence of the Hodgkin's or other cancers? Thanks.

Response from Dr. Dezube

You deserve a big pat on the back for getting through ABVD chemotherapy and radiation therapy for your Hodgkin's disease (HD). It's not an easy course. It is very natural to be concerned and fearful that your HD will recur. As time goes by, your concerns and fears will hopefully lessen, though I imagine that they will never go away altogether. The key is to go forward in life despite these concerns (something all Americans are learning to do after the Sept 11th attacks). Your chance of recurrent HD is quite small, though obviously there are no guarantees about this. A good CD4 and low viral load are your best protection against recurrent HD. Your CD4 count will indeed go up in time, though often it can take well over a year. You didn't state your age, but the older you are, the longer it takes for CD4 cells to recover. I would recommend that you stay indefinitely on HIV drugs and you should also be on something for PCP prophylaxis. In my own practice, I have had very few patients with HIV-related HD recur. Good luck.


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