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When is CMV treatment necessary in AIDS patients?
Jun 24, 2006

My T-cell count dropped to 15 and my viral load was 800,000. I was then started on anti-viral drugs. The medications have worked well in lowering my viral load (now 196) and raising my T-cell count (now 205). As a result of my low t-cell/high viral load, I now have pain, numbness, tingling, and cramping in my feet. Could this damage be from the CMV virus, and should I be taking medications against that virus if my t-cell count again drops below 50? I live on the island of Guam, and we do not have AIDS specialists here. I have heard that Thailand has great specialists, and it is not too far from here. Can you recommend a doctor, clinic, or hospital that I could contact and arrange a visit with before going to Thailand? Your advise would be greatly appreciated. I am also wondering about life-span expectancy. I am in my 40s and have just recently entered the AIDS phase of this disease. -JAM-

Response from Dr. Young

Thank you for your post. I'm glad to hear that we're reaching the South Pacific islands.

Based on the limited information that I have about your case, I'd be concerned not about CMV, but rather from peripheral neuropathy (PN). PN can be seen in patients with advanced HIV/AIDS even without treatments, but is more frequent among patients who are taking d4T (stavudine, Zerit). As such, I'd wonder about which medications you're currently taking. If d4T is one of them, a switch to an alternative NRTI, like AZT, abacavir or tenofovir might be of benefit.

To your question about life expectancy-- we get this one daily here at the forum; I expect that patients on successful regimens to live for many decades, quite possibly to live normal lifespans.

Last, yes, Thailand does have excellent HIV care- a quick search for AIDS service organizations in Bangkok might lead you to a doctor that can help.

I hope this helps. BY



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