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kidney problem
Sep 8, 2000

I have been pos for at least 10 years, with no meds. Recently my doctor ran tests and found I was losing large amounts of protein through my urine. He has been trying to get me to start meds for quite some time. I have resisted because I don't feel sick. Now he says it's time. I really don't want any drugs, but I'm wondering if we can treat this kidney thing apart from lifelong daily meds. I must say that my cell count is 243 and my viral load is close to 200,000!

Response from Dr. Feinberg

It sounds like you have HIV-associated nephropathy (HIVAN), which can progress fairly rapidly (within months sometimes) to complete kidney failure. No one knows exactly what causes HIVAN, but HIV has been identified in kidney tissue called the mesangium, which is a critical area for normal kidney function. It is time for you to get off your I-don't-want-any-medicine high horse and listen to your doctor. If you're lucky, and your HIVAN responds to antiHIV therapy, then you'll avoid dialysis. Do not waste any time smelling the flowers, readjust your attitude and start medication soon if you don't want to spend 3 days a week hooked up to a hemodialysis machine. (And a viral load of almost 200,000 is pretty high, and T cells of near 200 is fast approaching the danger zone for all other bad HIV-related illnesses.)


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