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ear infection
Oct 11, 2004

Dear All

I was diagnosed in December 2001 and since that time have continued to have a very good CD4 (around 800) but also a high viral load (averaging 90,000). About a year ago I got an ear infection, probably from swimming, and since that time I either suffer from an over dry ear with wax blockage, or, if I get it syringed, it fills up with a yellow exudation which turns into a substance like granulated sugar, gets quite painful if you interfere with it. It's almost always itchy and even if I don't touch it, I sleep on the side of that ear which makes things worse for the morning. I am trying to get an appointment with a specialist which takes an age in the UK, but wondered if this is something related to HIV ... or more to do with middle-age! (I'm almost 50). Thank you all. Simon

Response from Dr. Frascino

Hi Simon,

First off, 50 is the new 30. Next, with CD4s around 800, your immune competence should be excellent. I assume your persistently high viral load of 90,000 is due to the fact you have not yet started HIV meds, right? If that's not the case and you're already on HAART, you need to see your HIV specialist, get a resistance test (phenotype and genotype) and consider intensifying or changing your mediation regimen to hopefully bring your viral load down to the undetectable level.

As for your ear problem, sure, you could have picked up something swimming that has subsequently evolved into something more chronic. No, I do not think this is HIV related, particularly because it only involves one ear. Your HIV specialist should be able to facilitate an appointment with an ENT (ear, nose, and throat) specialist if he feels he cannot adequately diagnose and treat the problem. Possible causes include a fungal infection, eczema in the ear canal, and recurrent bacterial infections.

At any rate, I think you are on the correct path, Simon, it's a local ear problem and not an HIV problem.

Good luck. Stay well, youngster!

Dr. Bob

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