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Meds vs's body awareness. What should I do?
Nov 2, 2003

I have been Hiv + for 12 years. Keeping a track of my viral load/T-cells and the like about every 3 to 6 months. Three times I have gone up to between 89,000/289T and 180,000/230T. Each time I felt there was something in my system that was causing it. BUT, my doctor at the time took several different tests and found nothing, therefore responding with, "time to go on Meds". But I wanted to wait and see if my instinct was right. I waited/observed/searched. All three times I found an answer to the dramatic rise in my tests. 1st time undetectable ghonirea. 2nd time strep/influenza up in my sinuses. Both of which I had for nearly 1 year. My test results immediatly came back down to 30,000 to 45,000 and a T cell of about 325 to 400. Normal for me was 675. The 3rd time I was telling my doctor for over 2 years that I was becoming acid. Burning sweat, sore mouth around the edges, lukaplacia. This went on for 3 1/2 years with my viral load not going below 89,000 /289T the lowest. Once again it was "time for meds".

The question I have is, is this unusual or do doctors normally assume that the viral load and T-cell count should be the governing factor for going on meds? What if your own body can correct itself with an antibiotic if you find an answer to the cause of the change in test results instead of eliminating the cause as a side effect of killing off everything with these powerful drugs? I want to understand my reality better. To many of my friends are being put on meds immediatly as if they have no long term bad effects to your body or you might build up a resistance to the meds.

Note: I came down with a very bad acid reaction 1 1/2 years ago and got a dehabilitating case of reactive arthritus. All the drugs for that were not helping much. My viral load went up to over 150,000/235T and at 53 years old I was loosing the ability to walk and hold things in my hands in just 2 months. I then started taking Coral Calcium to reduce my acid levels. The Arthritis started to subside in weeks and within 8 weeks was gone. My acid level went to about 6.4 . Within 1 year my viral load was back down to 20,000/340T. My acidy is gone now along with 3 1/2 years of hairylucaplacia. Meds vs body awareness. What would you choose in my case?

Response from Dr. Pierone

I think that you are right that body awareness is crucial in deciding when to start therapy. You have had other infections that were interacting with your immune system and evidently putting upward pressure on your viral load and downward pressure on your CD4 count.

Having said that, the CD4 count and viral load should be the determining factor for deciding when to start therapy (aside from HIV-related symptoms). These are the best that we have to go by given current state of knowledge. But your point is certainly valid, if a series of infections are making the numbers worse, treat the infection and see if things get better (as in your case). The counter argument (there is always the counter argument) is that had you been started on HIV medications several years ago your CD4 counts would be much higher and you may not have come down with a series of infections and inflammatory arthritis (but perhaps not).

The HIV medications really don't kill everything off, just the bad virus that is systematically destroying the immune system. They do have side effects, of course, and this is what holds us back from treating until the CD4 count drops into a zone that has been associated with immune problems.

Finally, people that are assertive and involved in their treatment decisions have better health outcomes. You clearly have been engaged in the decision making process and have made the right choices for your situation. Stay on top of things and be open to the prospect of starting treatment if CD4 count drops below 200 or if these chronic symptoms continue cropping up. Good luck!



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