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Whether or not to get second opinion
Jan 13, 2013

Hi. I was diagnosed HIV+ in december. My doctor thinks i was infected about 6 or 7 months ago. I recently got my first labs back and i have a CD4 count of 659 and a VL or 10,600. My doctor doesn't think i should start meds yet and i have persistently swollen lymphnodes in my neck. They aren't painful and they aren't growing in size but he wants a biopsy done on them anyway. I was wondering with those lab numbers do you think i should start meds now or wait and if the lymphnode biopsy should be anything to be concerning?Thank you in advance for your help.

Response from Dr. Holodniy

With your current numbers there is no urgency to start HIV meds. Your CD4 count is in the normal range and your viral load is at a low-moderate level. Your swollen lymph glands could very well be related to acute-early HIV infection, if the timing of infection is accurate. Usually lymph glands that become swollen in reaction to acute HIV infection shrink back down after a few months. In some people they may persist for a long time and it could still be related to HIV infection. However, it is not unreasonable to obtain a biopsy to confirm this or determine if there is another cause like another type of infection or tumor.



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