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CMV, TOXO, Thrush & CD4 of 60

Jul 25, 2010

Hi I wrote in several months ago regarding my sister-in-law and her toxoplasmosis. She is now back in the hospital with more lesions. The doctors believe she has toxo and cmv and she went in with a bad case of thrush. When she entered the hospital a week ago she was eating, awake and being pretty normal except for having a really bad headache. Everyday she has detiorated and now sleeps most of the day in spite of being given ridlin to try and keep her alert. Her eyes look flat like a blind persons but she says she can see. The doctors have told us they don't know if she will get any better but they are still trying several medications. Her CD4 is 60. She is unable to eat or drink can't get out of bed and has to wear a brief. From Tuesday to Sunday her lesions got bigger and she developed several new ones according to mris. My question is this they started CMV medicine on Sunday (3 days ago). When should we expect to see improvement or do you think we will? There are 3 children involved and we need her coherent so that she can sign papers on where they are to go in case she doesn't pull out of this. We don't want their father to get them because first he has nothing to do with them but we think he may try for the SS money. Secondly, he is the reason she has this horrible disease. Several years ago he was going around having sex with women without telling them he was positive. He went to prison but got out a few years back. Please give us your opinion. I wrote in a couple of days ago with more detail but never received a response. Please help.

Response from Dr. Holodniy

If this is a CMV brain infection, you should start to see some improvement by now. I assume they are doing all the appropriate work-up (scans, spinal tap, or perhaps brain biopsy) in order to get her the appropriate treatment. What would help most would be HIV medications that can increase her CD4 count so that her immune system can better fight and control these infections.

drastic drop in T-Cell Count
VL increase from undetectable, CD4 remain almost the same

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