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Heart Attack Revisted/Need Your Help
Jul 14, 2006

Hi Dr. Wohl,

I wrote to you back in April with "To Burp Or Not To Burp" regarding what we thought was a stomach issue. I followed-up to let you know after the MI and emergency open-heart surgery that it was in fact a heart issue. Well now I'm in the ditch. I was well on my way to recovery in June when I suffered another MI. I'm told I have Severe Diffuse Distal Coronary Artery (Small Vessel) Disease and there is not effective treatment. My prognosis is continued MIs to heart failure and death or sudden death from arrythmia. I decided to look around and found that indeed there is a couple of options. One and the most promisiing is Adult Stem Cell Therapy but here's where the HIV part throws a wrench into the works. I've been turned down everywhere. Some doctors are saying it's because the "outside lab" does not have a separate clean room to process my sample away from others and two docs have said that the progenitor cells from the stem cells would be contaminated with the HIV and spread like wild fire and give me full blown AIDS within 48 hours. One doc said he saw the replication in the culture. I sent back a question as to whether that replication was seen in the presence of antiretrovirals and got no response. The other response I received from a doc in Germany stated that he was afraid that injecting stem cells in my heart would spread HIV infection from my bone marrow to my heart. Isn't the heart like most tissue in the body already infected? Maybe something got lost in translation. The only other option for me seems to be Vasal Growth Factors which have failed in U.S. Clinical Trials. I realize you are not a stem cell expert but maybe you could shed some light on the replication issue. I just need some clarity if you can provide any and feel free to run this by your colleagues because I'm at a loss. Such a shanda!! I'm only 45 and in good shape. Sadly, this heart disease is the same one that killed my father at an early age. When diagnosed with HIV in 1997 my VL ws 2.2 million and my CD-4 was 153 and I presented with PCP. I'm stable below 50 on the VL and my CD-4 is almost 1300. Any guidance from you would be greatly appreciated.

Thanks and unbreak my heart. :)

Seminole in ATL

Response from Dr. Wohl

Dear Semi,

I have to confess that I did not even know that stem cells were used for this condition. I will check with some cardiology pals to see what I can find out.

At first glance, I agree that if your viral load is less than 50 the risk of massive spread of HIV seems unlikely.

Additionally, if the only issue is risk to you, an argument you could make to a reluctant physician is, 'what do I have to lose?'

I will let you know more when I do.

DW



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