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Apr 29, 2012

Hi, I live in Nigeria, I'm a 43 years old male. I tested positive sometimes in Feb 2012 during treatment for malaria parasite which is quite prevalent here. I usually for about 2-3 years test positive to malaria or typhoid on a 5 weekly basis. While on malaria treatment in feb this year my doctor discovered my white blood cells were low and tested for hiv which came in positive. I had some confirmatory tests that gave mixed results, one said NOT NEGATIVE, another said INDETERMINABLE CHECK IN 3 MONTHS. At that point my Doctor decided I should run cd4 and western blot tests. Specimen was collected on 19 feb 2012, result was printed 29 feb 2012. The results which is now in doubt shows a cd4 of 198, western blot hiv1 as indeterminable, western blot hiv2 as negative. A viral load test was recommended and sample taken 29 feb 2012. My doctor placed me on TRIOMUNE (Lamivudine, Stavudine and Nevirapine) tabs.

The results printed on 13 mar shows a cd4 of 411 and viral load of 35299 cps/ml and log unit of 4.55. My general health improved afterwards until early April I started feeling weak and irritated, my doctor said its as a result of one of the components of the Triomune and started me on another first line drug AUROBINDO (Zidovudine, Lamivudine and Nevirapine) tabs on 16 April 2012. I became weaker and was directed to stop the hiv drugs to conduct further tests of cd4 and viral load in two different labs. The results of one show a cd4 cell count of 421 and CD4 CELL % 30.40% viral load of HIV-1 Log units of 2.718, and HIV-1 RNA copies 522 cp/ml. The other lab only did cd4 with results as 548.

My doctor told me that we shoudnt have started the hiv drugs at all and that he will put me on immunance and watch how things goes, suffice to say am feeling better now. I am confused and want to come to the USA to run further tests to confirm how things goes. Pls your advice in this regard will be well apprecited. Thanks.

Response from Dr. Holodniy

Well I don't think the diagnosis of HIV infection is in doubt, given the repeated HIV viral load test results. The difference (reduction) in HIV viral load results are the result of a HIV treatment effect. I can't explain all your symptoms on HIV meds, although we do see that in some patients they feel worse before they feel better. And sometimes we have to try different combinations that have less side effects before we find a combination that will work and that a person can tolerate.

Detectable again but CD4 continues to increase.
Persistent HBV viral load

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