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Educated guess?
Oct 15, 2001

Dr. Feinberg,

You responded to a question about living for another 5 years and being honest with your doctor. I noticed you said that it may be possible to make an educated guess as to when initial infection occurred based on cd4.

Me: 35 m hiv+

70 cd4 350k vl diagnosed 9/01. I had chest discomfort every afternoon at work in 1999 and saw family doc. High blood pressure, givin rx for calcium channel blocker and referral for blood work.

Never had the blood work done as the symptoms got better.

8/01 discomfort again only in afternoon and feeling a little weak and noticed I seemed to be bruising pretty easy somehow.

Saw family doc again. got bloodwork done. High colesterol, ok Blood pressure, bottom low but still within normal range white and red blood count.

Doc saw no need to medicate or do anything. I wanted to know about the bruising and he gave referral to hematologist. Hematologist gave rx for iron for low rbc. Said i might want to take hiv test. I asked shouldn't i do that anonomously and he said he didn't see why, so i did it. I felt pressured, my mistake...

About being honest, I have never had any illness, cold, ache or anything other than what Docs attribute to hypertension that runs in my family. I can't identify how I developed my infection, and I am not ready to share this info with everyone I've ever met. At the same time I would feel such heart ache if I gave this to someone else. How many years back should I inform possibly exposed women. I have had three relationships since I was 18. If you could make an educated guess maybe +/- five years it would help me.

Thank you

Response from Dr. Feinberg

With 70 CD4 cells, you have likely been infected for 8-10 years at this point. You need to be on some form of prophylaxis for PCP, and you would benefit greatly from combination therapy for HIV. Technically, you have AIDS because your CD4 cell count is less than 200. Your low CD4 cell count and high viral load puts you at high risk for HIV disease progression and the development of opportunistic infections. Try to find a doctor who has expertise in HIV disease and who will be knwoledgeable enough to put you on the right medicines. Good luck!


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