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Fatigue and AnemiaFatigue and Anemia
          
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CD4 10
Aug 31, 2000

Just found out that I have AIDS and this sight is a God send.I have a cd4 count of 10. I don't really feel tired however I get cold easily. My Dr. says I am a little anemic should I be more concerned. Should I insist that we start some sort of treatment.

Response from Dr. Frascino

Hi,

Yes, I agree this web site has a wealth of information. I'm pleased to hear that you have found it helpful.

Now, on to your question. With your recent diagnosis and very low CD4 count, your first order of business is to consider treatment of your HIV disease with the hope of restoring your immune system. Potent antiretroviral therapy, often termed HAART -- highly active antiretroviral therapy -- has been shown to be remarkably effective in slowing down viral replication and thereby allowing CD4 count to replenish. Higher CD4s will help protect you from opportunistic infections. In the interim, you should be taking prophylaxis against common opportunistic infections, such as PCP and MAC.

As for your anemia, it depends on what your physician means by "a little anemic." Intolerance to cold is a classic symptom of anemia. Fatigue is also very frequent; however, it may occur insidiously as we make adjustments to our lifestyle to compensate for decreased energy level. Once the anemia is treated, we can often look back and realize just how much we have compensated. Check your lab slips. The lower limits of normal for hemoglobin are 13 g/dl for men and 12 g/dl for women. If your hemoglobin is 11 or less, treatment should be considered. The treatment of choice is Procrit, which stimulates your system to produce additional new red blood cells. The recommended dose is 40,000 units once per week. Treatment of mild to moderate anemia with Procrit in the setting of HIV disease is associated with improved quality of life and survival. Best of luck to you. As you embark on treatment, don't hesitate to write back if you have additional concerns or questions.

RJF


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