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Slow to test CD4 and viral load
Mar 23, 2005

I live in Thailand with my husband, who was just diagnoised with AIDS and toxoplasmosis two weeks ago. The doctors have not taken a CD4 count or a virial load, and are not set to do so until March 31st, then we will not know the results until the end of April. I am concerned because it seems to wait almost two months after the initial diagnosis is a huge risk, when we already know that his CD4 cells must be very low. What do you think? Should we be more demanding to get my husband's blood tested? Thank you.

Claudia

Response from Dr. Young

Claudia-

Thank you for your post. I am very sorry to hear about your husband's diagnosis.

The fact that your husband has toxoplasmosis indicates that he has a very low CD4 count (usually below 100)-- I wouldn't need a laboratory confirmed CD4 count to initiate therapy in this circumstance. Clearly there are some differences in how doctors practice medicine in different countries-- sometimes these differences reflect different opinions, other times relate to the availability of medications and diagnostic testing.

So rather than insisting on a CD4 cell count, I'd want to see your husband on combination HIV treatments in addition to the treatment for toxoplasmosis. Expect to see periodic testing of CD4 count and viral load, whenever possible, but the absence of these labs in this particular situation should not be a deterrent to getting antiretroviral medications started.

Let us know how things go; wishing you and your husband improving health, BY



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