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HIV/Shingles & Postherpetic Neuralgia

Apr 5, 2009

This is a complicated disease for us to understand and we are still in shock over his diagnosis. Prior to our meeting I had read that AIDS classification is when a patient has a CD4 count <200. When I heard his count was 468, I was thrilled. I did not understand the significance of the viral load count at the time and was not able to ask informed questions.

The intent of this letter is two fold:

1-To better understand the disease, and help set our expectations for the future. Six weeks is a long time to wait to get some of these questions answered.

2-Help expedite finding the cause of his leg pain. It is the main obstacle for him to return to work at this point.

I have been reading and researching on the internet to understand more about my fathers situation. The most alarming data point Ive encountered is that the CDC classifies AIDS as a patient with a CD4 count <200 or a %CD4 < 14%. His %CD4 is 13%.

I know that my dad asked you to ease us into this but we all need to face the reality of the situation and understand what were facing. I do not live in Miami. I spend some time here in the winter and would have left by now, but am still here due to my fathers situation. I am committed to staying as long as needed but would like to understand

Im sure that you will need to see all the counts in his next blood test to determine the progression of his infection and what we are really dealing with here.

I want to make sure Im understanding things correctly, and have several other questions. . My father is aware I have sent you this letter and has no problem with you discussing his situation with me. You can call him to confirm if you need to.

1-The goal of the drug treatment is to reduce the viral load, which will then slow down the decline of the CD4 cells. Is this correct?

2-Just generally speaking, what kind of decrease can be expected in the viral load of 398,000 at his age?

3- Can the CD4 count increase from treatment?

4- Can the %CD4 increase from treatment?

Shingles.I read that people can have shingles without the rash.

Response from Dr. Holodniy

My responses are only through this mechanism. 1. Yes. 2. On appropriate HIV treatment, he can expect his viral load to become undetectable. 3 and 4. Yes, and they will. 5. Possible.

My first HIV Viral Load Count - Help translate?
Bat vision non CMV

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