Aug 10, 2003
I am 36 and I was diagnosed as HIV+ last summer (2002). I got a really bad throat infection last summer, that took a month or so to clear up, my HIV status did not come out until my yearly physical in August. I caught my HIV status very early. Thank God!!! My Family Doctor referred me to see a infectious disease Doctor which I did. He immediatltly put me on (Sustiva, Videx, Viread) and also (Bactrim and Diflucan) so far I have good results. The reason for the Bactrim and Diflucan is cause my Tcell count was low he wanted to build a safewall for me not getting infections or to get sick. I believe my tcells were at the time like 55, my tcells are now at 89. I have a new job and new healthcare coverage. I was somewhat forced to see a new doctor that was listed in my healthcare plan. He also is a specialist and good. He has only done one blood work on me. And the result of that were tcells 89, viral load less than 50 (undedectable) he is suggesting I go on the Luekine/IL2 treatment . . . I know very little about this treatment and I am finding out my insurance will not pay for most of this treatment . . . am I in any danger of not doing this treatment? I have friends who are willing to go to Mexico to get the treatment for less. Is this wise? I don't drink hardly anymore, don't smoke, try to eat healthy, take lots of vitamins, I drink aloevera juice once a day. And I take my meds every day faithfully. Since finding out of my HIV status . . . my tcell count has risen, but its rising slowly. What are your suggestions and/or recommedations on my situation.
Response from Dr. Pierone
Your situation is very somewhat unusual. Most people that are diagnosed early and treated and successfully have CD4 counts over 500. Have you had serial HIV tests over the years confirming negative status prior to this recent positive test?
Nonetheless, the question is, in view of the sluggish CD4 count response to treatment, should you try IL-2 to boost these numbers? This is an experimental approach at present time, but certainly a reasonable consideration. Our team is involved in the SILCAAT study, which is examining the potential benefit of IL-2 for those with CD4 counts between 50 and 300 cells and controlled viral load. Half of the patients are observed on antiretroviral therapy only and the other half are treated with cycles of IL-2 in addition to the meds. We won't have the answer to this study for several years, but the good news is that both groups of patients are doing extremely well. If you do decide to start IL-2 be aware that there are significant side effects. The majority of people get flu-like symptoms that are sometimes quite severe. Rarely, more serious side effects may occur as well. Aside from this study situation, my current practice is to sit tight with patients in your situation and simply continue antiviral therapy. Since your CD4 count is rising slowly over time it should continue to do so and eventually you should get to a safer CD4 zone. Studies are showing continued immune restoration over time in those with well-controlled HIV and I suspect that over time your counts will progressively improve. Good luck and give us an update in the future.
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