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need more info on noncompliance
May 22, 2000

You answered my question regarding daughter with AIDS going to Puerto Rico. Despite thinking she would take her meds, she has not. She hasn't taken any in about 2 months. Last cd4 was 130. She is 17 & still runs on track team. Without treatment how long do people usually live once they have AIDS? She has AIDS because of cd4. Has not had any illnesses. If she goes to Puerto Rico I think she will probably get a GI infection of some sort. Can this be fatal in someone so immunocompromised & not on meds?

Response from Dr. Feinberg

Some HIV+s do not get sick until their CD4 cell count is very very low (less than 25), others begin to get sick much earlier, with Cd4 cell counts higher than your daughter's. There is no way to predict exactly how soon that will happen, although her HIV viral load may give some clues -- the higher the viral load, the greater the chance that someone will get sick in the near future.

I have found it very hard to get my teenage patients to accept HIV therapy and stick to it. There is something about being young that makes them feel invulnerable, even when they have AIDS on the basis of their CD4 cells, as your daughter does. Your unqualified love and support will probably be what is most helpful to her; don't nag her to take her meds and perhaps in time she will. (Teenagers are very rebellious, as you probably know all too well.)

There are a couple of intestinal infections that are not currently treatable, although people who start taking potent combination HIV therapy sometimes clear the organism on their own. These infections occur in the US as well, and are not fatal immediately but can lead to a very run-down state and poor nutrition, which can make you susceptible to other problems. However, most GI infections can be treated, whether she picks them up in Puerto Rico or elsewhere. Encourage her to seek medical care at the first sign of something going wrong, and good luck!


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