Feb 21, 2009
Greetings Dr. M! I'm HIV+ (undetectable on Atripla), cleared HVC at 4 weeks, now w/ 10 weeks to go (38 done)on pegylated interferon/copegus. I had very high levels of Epstein_Barr virus found w/ non-Hodgkin's lymphoma large cell B (in remission 2 yrs) and a history of malaria. My T cells are low (100 given inteferon therapy, cell % good) Do I ever get treated fro the Epstein-Barr or malaria? My IF doctor said he doesn't know. Heptologist says "that's a good question" but never has any answers. My inyternist says EBV is nothing to worry about ... but it almost killed me. Any advice? Thank you.
| Response from Dr. McGovern
You have multiple good news points:
1. You have a non-detectable viral load on Atripla 2. You are responding beautifully to HCV treatment and have a high chance of cure due to the rapid response at 4 weeks. 3. You are in remission for lymphoma.
Since we don't have a specific antiviral for EBV, I think the most important issue is to keep your immune system healthy. Although your CD4 count has gone down, we expect that on interferon. That is why I never look at the CD4 counts while a patient is on interferon - I only look at the CD4 percentage, which in your case is "good".
I think cure of your hepatitis C infection will also be good for your immune system so keep taking your medications faithfully. A good immune system will keep your lymphoma hopefully in check.
Hope this is helpful and most of all reassuring. Sounds like you are making wonderful progress.
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