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Should I worry about dental infections and colds/flu not on meds?
Sep 30, 2009

I'm not on meds yet. CD-4 around 800. VL 24,000 at highest reading but 6,000 last test. My doc wants to wait to put me on meds. I have had much anxiety about my health since learning my HIV status late last year. I actually think my physical health is pretty good; however, I think all the anxiety is causing me to not feel so great sometimes.

I'm worried going into cold/flu season not on meds. My doc and others say I don't have anything to worry about with high CD-4 count. I find myself noticing everyone in public who is coughing or sneezing and I go out of my way to avoid them. I wouldn't visit friend in the hospital, because I've read hospitals are full of viruses, bacteria, etc. I just feel like I'm so fragile now.

For instance, I recently had a filling come out of a root canal. I just got a very sore lymph node/gland and my ear has been very sore--on the same side as the tooth. There is obviously an infection or something. I can't get into the dentist for a few weeks. They are having me take penicillin until I can get in.

Some have said I'm worrying myself to much and that HIV doesn't just cause you to drop dead. Rationally, I know that is true; however, I just feel like any kind of infection could kill me. Even with good CD-4, I've read where my CD-4 of 800 is not the same as HIV neg person with 800. I read mine can suddenly crash from some infection or illness--basically their body is going to fight off an infection better than mine.

Am I right to be so concerned about all this and not being on meds? Or, do I need to chill? I know so many HIV-NEGATIVE people who are sick all the time with one thing or another, so I know I'm probably being irrational.

Thanks so much.

Response from Dr. McGowan

What you are feeling is very understandable when you have recently been diagnosed with HIV. Many people go through the same anxiety until you realize that you are not as fragile as you think.

It is certainly wise to take precautions during cold/flu season to remain healthy. What you read is true that CD4 counts can drop temporarily during a bad cold or the flu (this happens in all people) as the CD4 cells move out of the blood into the tissues to fight the infection and get consumed in that fight. This dip is usually brief (2-4 weeks) and then they go back up to where they were before. The best thing to do is to wash your hands frequently after touching things in public (especially before eating). Most infections are spread on the hands.

Taking good care of your teeth is very important. Regualr brushing, flossing and dental checkups are part of routine care for a person with HIV. Gum disease and gingivitis are more common.

Your CD4 count of 800 is strong enough to keep you out of danger from the "opportunistic" infections that are related to HIV infection. People can start meds at high CD4 counts, but that decision should be made carefully with a committment to not miss doses and work with your doc to manage any side effects. You do not want to rush into that committment or trade one set of worries for another (fear of toxicity from the medications). Have a discussion with your doc about your worries, over time you will realize that you have the opportunity to carefully plan out your treatment.

Best, Joe



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