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Thanks, and fungal question
Jan 1, 2007

Hi Dr Wohl,

Thanks for answering my recent request (and answering all the requests no matter how many times you're having to repeat yourself). I'm the person in the Durham area that was recently diagnosed, and was having trouble getting into Duke.

Through a good series of events, I was able to get in to see a Dr (Dr J.A.Alspaugh) and we got the ball rolling on my initial testing.

I'm understandably anxious for the results but with the holidays it's delaying everything...

I'm writing down all of my questions for my next visit, but I was hopeful that you could possibly address one that I'm probably fixating on. ;-)

Prior to my diagnosis, I already had what I would call a generally weak constitution (allergy shots for 13 years as a child, past exposure to Toxo 20 years ago, pneumonia 13 years ago, a "Hepatitis like" infection 7 years ago [not A, B, or C], general "fungal" susceptibility, et.al.). Is there any kind of data around long term prognosis for people that may have had a "naturally" low CD4+ count prior to infection?

THANKS!

Response from Dr. Wohl

Do you know if your CD4 cell count was actually low prior to your infection with HIV? There are some people without HIV who do tend to have low CD4 cell counts. At the extreme, this can lead to an AIDS like illness and the prognosis can be poor.

In your case, it just may be that you have had the misfortune to have experienced a series of infections either as a consequence of an immune system that is relatively weak or bad luck.

Any other people in your family with a "weak constitution"? Any of these people old? If so, I would not be too concerned that your pre-HIV immune function places you in peril. I would expect that once your HIV is controlled, you should do fine.

DW



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