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Treatment??
Oct 20, 2001

Dr Bob,

I wrote in to the treatment forum but have not heard from them and I really need your advice very soon. My partner is HIV+ and got his second round of lab tests. I do not like his doctor much nor do I trust his judgment, but he said in 3 years my partner would start seeing AIDS symptoms without treatment. Please help me Dr. Bob His first and second lab results are as follows:

May VL 35K CD4 700 Sept VL 46K CD4 642

He is clearly asymptomatic now, but his doctor has truly scared me to the point I am so worried and stressed I can't sleep (fatigued)--Sorry, figured I would add that hoping you would answer. I feel he has about 5 years left without meds but his doctor scared me stiff...either I am crazy or he is--please tell me he is...Luv ya!

Worried Chicago Partner

Response from Dr. Frascino

Hello Worried Chicago Partner,

Maybe that doctor is just trying to get into the Halloween spirit by trying to scare you. If he really could predict the future, he'd be quite wealthy and probably living in Las Vegas right now. Your partner is doing just fine at the present time. His CD4 count is excellent and his viral load is only marginally elevated. Most often, once someone gets infected, that person's immune system and virus will reach a sort of equilibrium often called the viral "set point." This equilibrium, different for everyone, is influenced by age, immune system response, strain of virus contracted, overall health status, and many other factors. Over time, the immune system does tend to poop out in most folks and that's when the CD4 count falls. On average, there is a gradual drop in CD4 count of 50-75 cells per year. But this certainly doesn't happen to everyone. Your lover could have 5 or maybe 15 years without getting into the range where we would consider starting treatment. What should he do now? First, he should find a doctor he trusts and with whom he can work well. It doesn't sound like his current physician is a good match. Check with local AIDS service organizations in Chicago. There are many excellent HIV specialists in that city.

Now, as for your fatigue, you are absolutely correct. Worry, stress, and fear are to blame. And, of course, not sleeping doesn't help! So, go work out at a gym, take a stroll down Michigan Avenue, have a slice of Gino's East pizza, pet a pooch, hug a tree, and snuggle with your lover. Most importantly, I'm sure you'll feel better after you get established with a more reasonable HIV specialist. Continue to monitor your partner's counts every 3-6 months. Stay informed and involved. Leave the worry and fears to Mr. bin Laden. He's really got something to worry about.

Good luck. (Luv u 2)

Dr. Bob


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