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+ppd and - chest X-ray.
May 30, 2004

Dear Young,

I have a +ppd and -chest x-ray and I am 36yrs old.My doctor pescribed Pyridoxine(B6)and Izoniazide.I took these drugs for seven weeks and it was found out that my liver was being affected and I was asked to stop.

Also my last blood work showed an increase in VL from 17,000 to 34,000 while the CD4 remained at 478.Now my question is; I my due for initiating therapy? could the latent tuberculosis come up incourse of treating HIV? was the seven weeks treatment enough?.My next appointment is June ending and I will love to hear from you.

Response from Dr. Young

Thanks for your question.

I don't see anything in your tests that strongly suggest the need to start treatment for HIV. Most doctors in the US are waiting until CD4s are about 350, particularly if the viral load is higher (>55,000). In both cases, your lab tests have not met these criteria.

While seven weeks of treatment for TB preventive therapy is not thought to be long enough, there's no obvious reason that starting HIV treatment will activate TB.

Good luck, BY

Baseline VL?
Starting Treatment

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