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How to plan the future with HIV
Aug 25, 2011

Dear Dr. Bob,

First of all many thanks for all the information that you are sharing, it is a great help for a lot of us!

In my case I am HIV infected for a year now. Things are ok my CD4 count was in March 2011 1429 and I had a viral load of 110. Both still pretty good.

Slowly I am changing my lifestyle. We have a son and I want to be around as long as I can. The only thing I think I am suffering from is a bit more fatigue but for the rest I feel pretty much the same still.

What more can I do to stay healthy as long as I can. I am confused about a few things: - My stressful work is taking a lot. Should I change to something easier to stay healthy longer? - Should I think about starting medicine to even cut down further on my viral load? If not what would be the time to start thinking about therapy.

I wrote before but maybe my question was not as clear. I hope you will find time to answer, I am concerned that I am not knowing everything to live a healthy working life as is possible. We need our income but could do with less money longer. How do I stay healthy and in the race....

Best regards, Jules (From Belgium)

Response from Dr. Frascino

Hello, Jules from Belgium.

A complete discussion of how to stay healthy while cohabitating with HIV is beyond the scope of this forum (HIV prevention and safer sexual practices). You should be discussing this topic with your HIV specialist physician at every visit.

Addressing your three concerns:

1. HIV-associated fatigue is common and often multifactorial in nature. Review the information in the archives of the expert forum dealing with fatigue and anemia. There you'll find whole chapters devoted to the causes of HIV-associated fatigue as well as treatment of HIV-associated fatigue.

2. Excess stress can be harmful. Talk to your HIV specialist physician. He will be able to evaluate your specific medical and work situations and make the appropriate recommendations if a reduced workload is desirable or necessary at this time.

3. I'd suggest you review the information in the "Resource Center on Starting HIV Treatment" that can be easily accessed on The Body's homepage. Recent published guidelines recommend beginning antiretrovirals when the CD4 count drops to 500. Some HIV specialist, including yours truly, recommend beginning treatment as soon as the HIV-positive diagnosis is made, even if the CD4 count is well above 500, to protect immune function and prevent damaging immune activation/inflammation.

Stay well, Jules. Let's both be here for the cure, okay?

Dr. Bob

Will be donating $10

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