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debilitating syphilis and t cells
Aug 4, 2003

Sometime in Sept. 2002, I caught syphilis. I got measles like rashes, thick hardened mucus in my nose, a sore throat, blotchy hair loss, extreme pain in lower legs(shins) and lower arms, complete sleep disturbance, weight loss, ringing in my ears eventually getting very loud. I became almost debilitated. I'm broke and finally went to a clinic after dealing with all this for at least 4 months fearing I was about to die. I was tested for HIV at the same time. I was treated with one shot of pencillin type drug for the syphilis, and a weeks worth of doxy for NGU. I was notified of my HIV positive status, and found a clinic to go to. Furthur blood tests revealed my t cell count to be 200, and my viral load to be under 10,000. I have no thrush, neg CMV, neg Toxo, neg Herpes, Pos Hep B(no symptoms). At this time I also had an ongoing basal cell carcinoma the size of a lemon on my back(been there growning 10 years). The doctor put me on Bactrim, and Combivir and Sustiva. I haven't started yet, I'm now recovering from the skin cancer removal and grafting. QUESTION: Is it possible that my immune system was keeping the HIV in check, and that the syphilis brought down my t cell count? I will start therapy, but I want to know if my t cell count is going to go up(and if it was actually lower at some point before my treatment for syphilis) on it's own. I have recovered slowly but steadily from the syphilis and I feel well. I'm not trying to be ignorant, but I want to give my body a chance. Because it is a "charity" situation, I don't think the doctor appreciates anyone doubting her. THANKS

Response from Dr. Pierone

Hello, I do not know of studies that have looked that effect of syphilis on CD4 counts but it is plausible, possibly expected, that it might bring CD4 counts down. It almost always makes sense to get more than one CD4 count before starting therapy because these counts can vary so much. At the very least you get a better sense of baseline immune status. In your situation it might be helpful to see what trajectory of your CD4 cells as you recover from syphilis as well as the surgery and skin grafts. The other reading that might be helpful is the CD4/CD8 ratio, if higher than expected (about 0.2) that might suggest better immune function. Good luck!

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