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Candida
Aug 1, 2002

Dear Doctor Please HELP ME, I been tested positive on 22 /02/002 preious I been tested negative Jan. 2002- Sept. 2001 Today I been to se my doctor and I have on my mouth Candida, regarding my Doctor opinion I am on second stage, is possible? I never have any simptom only 4 days of fever, he give to take some medicin as CO-TRIMOXZOL F 800mg Trimethoprim 160mg Vitamin PP and Caroten, Medication for fungus.Is possible I am on second stage? My CD4 is 478 I am living in Vietnam and is not machine for the viral load. Please give me any suggestion.

Response from Dr. Aberg

Unlike many other opportunistic infections that occur with a lower CD4 count, Candida can occur at any CD4 count. In fact, some individuals have oral candidiasis when they first acquire HIV and have what is called primary infection. Also, some individuals get oral candidiasis that do not have HIV but may be related to other immune deficiencies or antibiotic use or other factors. The presence of candidiasis in someone with HIV who has a higher CD4 count may be a reflection of progressive immune deficiency and your doctor is following the recommendation that you may be at higher risk for developing other complications of HIV such as pneumocystis pneumonia (PCP). Hence, he has started you on co-trimoxazole (sulfa/trimethoprim) to prevent PCP. I agree with this. It is unfortunate that you do not have access to HIV viral load testing but given you have oral candidiasis, I would recommend that you start antiretroviral therapy if it is available to you.



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