|Getting fatigue from work?
Sep 14, 2007
I started a new job in April, right after i had my lab work done...my cd4 was 488 and my viral was 62,000 (Not on meds) since ive been working I havent been sick at all, I love my job, but I am on my feet literally all day..I started getting extremeley tired at work a couple monthes into working, would start getting getting light headed and dizzy towards the ends of the days, then when i would get home i would basically crash. Well when I went in for my most recent labs...I was at cd4 282 and viral 110,000...My doctor told me it was because of the fatigue from work that caused my numbers to worse and wants me immediatley to start Atripla, And Im not sure how I feel about that, your opinion on the matter please? Thank You
Response from Dr. Frascino
Although I agree you shouldn't push yourself at work to the point of exhaustion, I would tend to doubt just being your feet all day would cause a rapid decline in CD4 count and rise in HIV plasma viral load. Could anything else be going on, such as an intercurrent illness, for instance? Generally speaking, untreated HIV-positive folks lose, on average, 50-75 CD4 cells per year. Your drop was much more precipitous. Therefore I would look for a potential cause other than just the natural course of HIV progression.
Second, should you begin HIV meds? Personally I would not recommend beginning treatment based solely on a single blood test result. If the evaluation into the possible causes of your declining CD4 count and rise in viral load is unrevealing, I would repeat your blood counts. If the CD4 count remains in the 250-350 range, HAART (highly active antiretroviral therapy) would be recommended.
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