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raped and infected with HIV and HepB
Dec 4, 2002

Dear Dr Fransino My name is richard i am 22 from the UK.I find myself in an unenviable position of being a victim of a drug rape and subsequent infection with HIV and Hep B.I am worried that my stress , anxiety and depression will trigger an early onset of AIDs i was diagnosed 6 months ago my cd4 count was 395 at the peak of seroconversion together with the Hep B infection , my cd4 has recovered to 890 now with a viral load of 3900 copies stable for four months .the Hep B has cleared. Do you think i should start any treatment the doctors here dont want to, but i am worried that the viral load will escalate.I am finding it hard to accept all this stuff especially after the police did not want to prosecute the man who did this to me.I am having psychological therapy but i fear i am emotionally/psychologically scarrred beyond repair.Sometimes i feel suicidal and i cannot bear to tell my family or friends. i am scared of dying from AIDs.I would greatly appreciate any advice you can offer. kind regards ritchie X

Response from Dr. Frascino

Hello Ritchie,

Sorry to hear about your nightmare. Trust me that things really will improve. I was infected over 10 years ago. Despite the challenges of living with HIV, I've never felt more alive. Continue to work with your therapist. The psyche can get wounded and hurt the same way we can break a bone. It can also heal and mend with time and proper medical attention. Are stress and anxiety going to hasten the course of your HIV disease? No. In fact, some degree of stress is actually good for the immune system. Excessive stress, however, leads to fatigue and depression, which can make us feel quite miserable, but really won't have a significant effect on your immune response to the virus.

When to start therapy is a very personal decision. The latest guidelines indicate that the best time is when the T-cell count is in the 250-350 range. The reason not to start earlier is to avoid possible drug toxicities. I can't tell you what to do. But, if it were me, I'd monitor my T-cell count and viral load every 3 months and hold off on therapy until the CD4's were around 300. Talk to your HIV/AIDS specialist. Also, search around on this and related websites for additional information about treatment guidelines. Get informed and stay involved in all your treatment decisions. You are not alone. Let's get through this together, OK? Good luck.

Dr. Bob


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