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Studies regarding OI frequency and tonsils
Feb 25, 2001

Dear Doctor,

This may be an off the wall question, but I am wondering if any studies have been done on the presence of tonsils and the lack of OI in a person with full blown AIDS. I have currently a TCell count of 113 and Viral of 136000, Just found out I am positive. I am wondering because I have had absolutely no OI and feel great, but I do still have my tonsils and have been dealing with recurring tonsillitis for years. I am wondering about having them removed, but I wonder if in someway they may have been "protecting" my body from OIs. Is this a whacko thought or might it have some merit. Thanks

Response from Dr. Cohen

Unlikely.

No good reason that your tonsils matter much here - there is plenty of lymph node tissue scattered throughout the body, all working to do their part. It is hard to imagine why the nodes in the throat would have any particular protective effect about OIs elsewhere in the body. More likely that you are experiencing something we have seen in others - with a CD4 count over 100, OI's are still unlikely in the short term. The "big" illnesses - like PCP, thrush and others, do happen in this CD4 range, and probably would if you waited much longer to start meds. Other illnesses - like CMV, only happen when the CD4 counts are lower than this. And we do know that there are some who, despite low counts, are lucky... for a while. A low count puts you at risk for illness - but there are always some who do get sick while others don't. For reasons that remain unclear but the subject of ongoing interest. Some just have a better system that does better despite the loss of CD4 cells - while others are not so fortunate.

But, if you prefer, we can give your tonsils some of the credit.

CC


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