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Ask the Experts about Opportunistic Infections
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Really worried!
Apr 10, 2000

I am a mother who was diagnosed in 1998. At that time I had only eight cells left. When I was in the hospital, they treated me for cmv. After leaving the hospital, I was using an IV of ganciclovir In the morning and at night for a period of 3 months. The very next day after that treatment was completed, I began taking 1000mg of cytovene caplets 3 times a day. And currently taking them. So I now have been taking this medication for two years. I had cmv in my intestines. I just found out that cmv can be transmitted by saliva. Is this information accurate? Because I am puzzled why the doctors have never told me such important information as this. My concern is that I have two small children, 3 and 5 years old, who have tested negative for HIV. What about for cmv, can I speculate that they may be infected? If this is so, what precautions can I take around my children? Can they get it from drinking out of my cup or from my silverware? My viral load has been undetectable for a year and a half, and my cd4 cells are 289 as of today. April 2, 2000 Thank you,

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   Response from Dr. Feinberg

Actually, many adults get CMV from their babies, rather than the other way around-- it is one of the most common infections passed around in daycare centers. Children with healthy immune systems aren't at risk of anything bad from CMV as long as they didn't get infected before birth. There is a lot of CMV around in the world, and many people have been exposed to it without serious problems.

Besides, with your current CD4 cell count and viral load you are much less likely to be shedding CMV into your blood or saliva or any bodily fluid, which is even more reason to not worry about it. In fact, you have done so well that you might want to discuss with your doctor the possibility of stopping your chronic suppressive therapy with oral ganciclovir. As long as your CD4 cells remain above 100-150 and your HIV viral load is undetectable, the risk of your CMV reactivating is very small. You can check the AIDS Treatment Information Service website for the 1999 version of the Public Health Service Guidelines on OIs for more information.

Relax, and continued good luck!



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