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How long
Apr 6, 2008

My dad, who is 65 got diagnosed as HIV positive a few weeks ago. The western blot revealed CD4 of 34 and viral count of 275,000. He has become physically very weak although mentally he is still very strong. He has a very enlarged prostrate and lymphnodes enlarged in the stomach and elbows. He has been bleeding everyday as well during bowel movement from his colon. Although we have mentally prepared ourselves for the inevitable, I would like to know how much longer he has. He does not want to take any medication. Also what will be some signs that we will see. I know you probably get a lot of questions like these. But I would appreciate your thoughts and answers on this.

Response from Dr. DeJesus

Unfortunately your dad was diagnosed very late on his HIV disease and he apparently is having another underlying medical complication that is causing him to bleed. This other underlying medical problem may or may not be related to his HIV; but the HIV itself is not the cause of his bleeding.

One thing that you and your father should know: it is never TOO late to start anti-HIV therapy. The treatment for HIV are incredibly effective; and even patients with more advanced HIV disease that your dad, they have a decent chance to respond well to therapy. I would really hope your dad changes his mind regarding initiation of treatment and agree to start HIV therapy immediately.

Regarding his current illness, and how much time he has now, no one outside the circle of physicians involved on his care is going to be able to answer that question with any significant degree of certainty. It seems like he is very sick with a serious superimposed gastrointestinal problem, but his immediate prognosis will depend on what the real cause of his gastrointestinal bleed is. His current physician should be able to give him a possible diagnosis and a potential plan for treatment. Most of the conditions that cause gastrointestinal bleed are potentially curable; but there are few that are not.

My advice: ask his physician to give you a possible diagnosis for his bleeding and discuss what the options for treatment are. The advance stage of his HIV should not be the factor deciding if he should or should not start treatment. Seems to me that the stage of his other medical problem causing the bleeding is what should drive this decision. Hope you dad is able to make the right decision for him. Good luck!

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