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Long-Term prognosis
Jun 22, 2002

I wrote to you a fews days ago about my brother refusing treatment. We DID manage to get him hospitalized (brochitis & awaiting results for possible PCP infection). His viral load is 750,000+, his T-cells were under 20. He's 1st being treated with Antibiotics and then will be placed on HIV med's. In addition, his doctor is prescribing Home Health Care since he was also diagnosed with Depression.

He's been POZ for 12 years and has a history of Cocaine abuse (also smokes Marijuana and occaisonal use of Crystal. DOES NOT INJECT ANYTHING).

Assuming !?... He can give up the drug abuse AND stick to his med's what is his prognosis for long term survival? He feels he'll die very soon no matter what he does and so there is no point in changing life-style habits. Is he right? Is he that far gone (T-Cell, Viral Load, Weight loss)? Will he die with-in a year no matter the effort?

I don't want to see him give up but I also don't want him to spend his last days battling his demons for no apparent gain.

Please, what are his odds either way... are they any different?

Thank You.

Response from Dr. Young

Thanks for your follow up.

As you might guess, it's tough to accurately put a number of survival. Your brother's situation is pretty serious, given the active pneumonia and very, very low T cell levels. We know that the odds of successful therapy go down with lower T cell counts and higher viral loads-- in this regard, your brother will need a little luck, and I'd point out too, that probably a maximally potent regimen with a really big focus on adherence.

Despite these caveats, I have a number of patients who have made wonderful recoveries from just this situation-- overall, I'd think that the odds are pretty good; certainly better than 50-50; certainly good enough to counsel you (and your brother) to pursue very aggressive treatment.

Good luck, stay in touch. BY



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