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Therapy or No Therapy?
Nov 4, 2006

Please help. I have extreme guilt over persuading a friend to test for HIV. He was a healthy bodybuilder with a full and active life. He tested positive and began therapy. Now after 5 years of meds, he has all sorts of health problems including spastic colon, shingles, hip degeneration and the list goes on. He is suffering terribly and I wonder would he have been better off not even testing? What is better: therapy or no therapy until absolutely necessary? Thanks. Signed: Guilt Ridden

Response from Dr. Young

Dear GR,

No need for feeling guilty on this one. Your friend is lucky to have your friendship to persuade him to get tested.

On average many persons with chronic HIV progress to serious AIDS complications within 5 years, in the absence of medical intervention. By your persuasion, you may have actually spared him serious health problems, and maybe even death.

You suggest that he's having these complications as a result of testing or medications-- let me remind you that shingles occurs frequently among those with HIV infection (higher among those with late stage, untreated disease). Hip degeneration while somewhat more common (perhaps) among those with HIV is also common among persons who use anabolic (or other) steroids. It's quite conceivable to me that your friend's bodybuilding past may have something to contribute to this unfortunate situation.

It's not clear to me that your friend is suffering from medications, or if the medications have maintained some degree of health, but he's having difficulty with other HIV-related problems.

I can't tell you if HIV treatment was appropriate or not for your friend without much more information about his symptoms, CD4 count and viral load (just to start).

But, no, testing was definitely not a bad thing. Encouraging those who may be at risk to get tested is not a bad thing either.

I hope this helps you. BY

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