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Thai experience
Sep 6, 2004

My friend just know he is HIV+ .CD4 286 (12%) and No viral load test available in Thailand.Routine blood test all normal (WBC 5.8).He confirmed that his infection is within 18 months as he checked HIV negative 18 months before. Dr in thailand now precribed contrimaxazole daily, withVitamin B1, 6, 12 and Vitamin C and Folic acid daily, plus weekly dose fluconazole 200mg He don't have any visible symptoms now,lymph nodes Ok, no diarrhea and skin problems. It is controversal to use antiviral drugs to patient with Cd4 200-350, but it seem that his CD 4 is low . I don't know his CD4 was affected by the emotional upset during the few days he just tested positive.AS i know cortisol under stress might increase 20 folds that could reduce the Cd4 level. But i want to ask exercise and living with less stress can really increase the Cd4 count even without and antiviral treatment.

I only have one case for my reference, A chinese guy that test positve on May 2003 , then test CD4 every 3 months and the result was 268-->226-->298-->328 up to one year I am not sure this guy's low Cd4 during last year is due to stress or without any correlation.

Hoping that experts from States can give me some opinion to help him.

Response from Dr. Pierone

Generally, we use a cut-off of 200 CD4 cells to start co-trimoxazole (Bactrim, Septra) and even lower cut-off for Diflucan. 200 to 350 is the usual zone for starting antiretroviral therapy, but several readings should be done to help guide this decision. Exercise improves overall health and excessive stress interferes with optimal health. Thanks for posting and let us know how his repeat readings come back.

Kaletra and diarrhea
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