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WORK VERSUS HEALTH-TOUGH CHOICE
Jan 29, 2005

I am an American English teacher in Korea and facing a tough choice. I love my job and want to stay another year, but friends say I'm crazy to be away from treatment (as a foreignor, I can be deported). I've been positive for ten years and have always had CD4's around 700 and VL's under 5,000 when not on meds. My latest test in the USA (during a Christmas vacation break and while not on meds) showed a 650 CD4, 25%, and 77,000 VL. This isn't that different from my other results, but the viral load is certainly higher. I plan to come back to the USA one year from now. Or is that too risky? If I had a great job waiting, I'd return tomorrow -- but I don't and that worries me equally.

Response from Dr. Young

I don't think that you have to make such a difficult decision.

If you were my patient, I would not be recommending starting treatment with your current CD4 count. Your viral load indicates that you should continue to get periodic monitoring, but in and of itself doesn't (to me) mean that you must start immediately, or in the next several months (probably at least the next year).

Hope this helps, BY



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