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Fatigue and AnemiaFatigue and Anemia
           
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Fatigue/Dysfunctional
Aug 4, 2000

In Feb came down with the flue, CMV, pneumonia, Herpes, Rosacia, somewhere down the line had Hepatitis. Was tested in Feb for HIV and was negative. With fevers for 2 months and extreme fatigue I was out on short term disability for 15 weeks. Returned to work in June and after 3 weeks, caught a cold and was collapsing and unable to function. Went to the hospital, had a lymph node removed, don't ask me why. Then I was told by my boyfriend he had AIDs, and lymphomic cancer. I was then tested positive for HIV. My original test had a cd4 count of 362. Then went to ID specialist and count was 562, he said no meds and my exhaustion was due to anxiety and I should go to therapist more. He never even took a viral load count. I went to another ID and my VL was 125,00 but cd4 went up to 691. Still not on meds. Still fighting my immune system. I can work 2 days around the house then in bed for 4. PS, I was fired from job, for going on Long term Disability. Which I still won't get till end of Sept.

Getting bad black and blue bruises and facial dry patches with itchiness. Any suggestions, PLEASE?

Cat

Response from Dr. Frascino

Dear Cat,

First off if you are HIV positive and have active CMV (an opportunistic infection) you would have a full diagnosis of AIDS and it would be illegal for your employer to fire you. You may have qualified for long term or permanent disability in which case this would not be an issue, as you would have your benefits in place. I wonder about your CMV. It would be very unusual to have active CMV with CD4 counts above 100. Perhaps your lab tests indicated you had been exposed to CMV and now had antibodies to that virus. This is quite common and very different than active CMV that can cause major problems particularly with your eyes.

The fact your initial HIV test was negative may indicate that you were very recently exposed to the virus and were in the process of seroconverting (becoming positive). It can take several weeks for the HIV test to become positive. Your fatigue, fevers etc could have been part of your conversion reaction. Since you most likely contracted the virus from your boyfriend and you are a recent converter it may be worthwhile to get a resistance test -- especially if your boyfriend has been on any HIV medications. This test will let you know if the strain of virus you contracted is resistant to certain medications. Your fatigue level seems quite severe. Check with your doctor. He/she will run some tests to see if you are anemic or perhaps have other medical problems that might account for this symptom. Certainly depression can be associated with extreme fatigue. I would suggest you make fatigue the focus of your next visit to your doctor. Sometimes physicians get so focused on CD4 counts and viral loads that they don't address the problems that are bothering us the most at the moment. With a good history, exam and a few blood tests he/she should be able to determine what's going on and get you started on appropriate treatment. Since you are newly diagnosed get as much information as you can about HIV in general. This website has much to offer. Local support groups may also help. Your CD4 counts are quite good. I predict once you get some of these other matters sorted out you should start feeling significantly better. Good luck. Write back if you're still having trouble. Good Luck.

RJF


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