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severe anemia and HIV

May 31, 2003

approx. two weeks ago i fainted and was taken to the hosp where they immediately admitted me. diagnosis: severe anemia (Hb 6). i was given two pints of blood and put on an IV. in the process we discovered that i was HIV +. an endoscopy and bone marrow test was done to try and determine the cause of the anemia. both were negative and/or normal. no lymphoma, cancer or TB. my cd4 is 219 and my viral load results have not come back yet. after two weeks i was sent home yesterday with viramune, videx and epivir. next week i return for a colonoscopy as they still cannot determine the cause of the anemia. thoughts? i'm a little nervous about all this.... thanks!

Response from Dr. Young

Thank you for your question.

There are a number of causes of severe anemia among persons with HIV infection. It would seem to me that your doctors have done a pretty exhaustive search and have not found a cause-- as such it might be the case that HIV alone has caused your symptoms (it can).

Sometimes red blood cell growth factor (erythropoetin) can help restore the cell counts and reverse the anemia; in most other cases, particularly like yours, in persons with low CD4 counts, starting combination therapy with antiretroviral medications is the most important thing to do.

The combination of nevirapine/ddI and 3TC should be very potent and generally well tolerated-- make sure that you do everything that you can to not miss doses and make sure that you get good follow up (labs and clinic).. Good luck. BY

What combination should I start with?

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