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Co-Infected, B Symptoms, 20% weight loss, neg biopsy's, change in VL - no answers - HELP
Aug 30, 2009

First, let me say - I love that all of you make this site available to the public! Secondly, I am the wife of a co-infected man (since early 80's) with a HX of Hodgkin's (01) on treatment since the early 90's with an undetectable VL until 2 wks ago. He is S/P HEP-C treatment (currently undetectable for 6 mos) [did 4 mos of treatment - stopped due to side effects 4/3/09] - he has been having drenching night sweats, occasional low grade fever, 28 lb weight loss in 8 mos, fatigue, etc - had a lymph node biopsy - "fair sample" - NEG & a BM biopsy "fair sample" - NEG - and everyone says - "great he doesn't have Hodgkins - but he can not gain weight & symptoms continue & his recent VL became detectable <48 copies/ 1.68 log copies - he also changed his HIV meds while on HEP treatment due to interactions - now on Atripla - he's not getting better & no one is giving us answers - any suggestions where to go from here? It's long & complicated because it is ....thx for any insight

Response from Dr. Holodniy

You're correct, it is complicated. I am not sure I have much to offer here. The symptoms sound very much "lymphoma-like". I don't know if a PET scan would be of value here. You don't indicate what his current CD4 count is. If it is < 200, he still could be at risk for opportunistic infections. Any HCV treatment side effects would have dissipated quickly after stopping. Given his current HIV viral load results this does not sound HIV infection specific. Although frustrating, some times these things take some time to evolve sufficiently enough to become obvious or for other tests to become positive. But you have to remain vigilent and continue to aggressively monitor the situation.



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