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Strict Job Guidelines and Counts
Apr 29, 2003

I was planning on attending a school for a particular job, then getting hired with the government. Because of the importance of health and safety concerns for aviation, the gov't has strict guidelines on VL and CD4 counts to pass the medical. They say that at initial application, VL must not exceed 1,000 and CD4 CAN be under 200 and still get clearance. Doesn't it make sense that the VL should be of less importance than CD4 and wouldn't it make sense for me to appeal if they deny me with a CD4 of 535 and at time of last test, 3/06/03, VL 48,000? I know VL can vary greatly, so I don't see why the need in such strict standards on VL. I was told the only way for most to be <1,000 is with meds and I don't feel I should take them at this time.....

Response from Dr. Holodniy

Sorry, this question got buried. You face an interesting dilemma. You are in a bit of a catch 22. I don't know what is driving the decisions on viral load, unless their thought is that the risk of exposure and subsequent infection in the event of a traumatic injury is much lower, when the viral load is < 1000. You are indeed correct that given your current CD4 count and viral load, most experts (and published guidelines) would not recommend treatment for you at this time. Unless they have compelling reasons for denial, appeal would then seem in order.



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