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long term non progresser
May 29, 2005

I was diagnosed in 1988 w/HIV. At that time my CD4 was 1300+. After 17 years with no treatment and active alcohol abuse, I remain asymtomatic with CD4's in the 900 range and viral load @2020. I am also HEP C+. Irealize that I may soon need to take meds. I am allergic to both PEN and SULFA drugs. Will I have many treatment options as an uninsured patient? I'd also like to mention severely swollen saliva glands that whose orgins have been left unexplained.

Response from Dr. Young

Thanks for your post.

I'd agree with you that you appear to be a long-term non-progressor (or at least a very slow progressor).

I'm not sure by what criteria you'll need to start medications in the near future-- your CD4 count is very clearly in a range where most physicians wouldn't recommend starting (assuming that you're asymptomatic). Further, your viral load is very low-- consistent with the very slow changes in CD4 counts.

Hepatitis C, on the other hand might deserve further thought and treatment of HCV has improved in recent years. Knowing that HCV tends to accelerate HIV disease and vice versa might give incentive to treat HCV if indicated. You've not mentioned whether you have a detectable HCV viral load or not, but this is the first decision point in thinking about HCV treatment (and being penicillin and sulfa allergic shouldn't alter your treatment options).

Swollen salivary glands aren't that uncommon in persons with HIV, though deserve some medical evaluation to make sure that they aren't the early signs of something more significant, like lymphoma.

Lastly, if you have no medical insurance, it's still possible to receive medical care and therapies for HIV; you'll need to discuss your options with your doctor, case manager or AIDS service organisation for precise details.

Good luck, thanks for reading. BY


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