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Meds and Life Expectancy
Jul 29, 2012

Dr. McGowan, I really appreciate all of your previous replies. This site is extremely helpful to all of us who are trying to cope with the positive diagnosis.(especially when first diagnosed)

As you will know from previous questions: I am 57: first diagnosed in 11/2011: CD4 was 374: 20% lymphs: Last CD4 was 510 with 37% lymphs tested in 06/2012: No resistance Initial VL was 46,000. Currently undetectable: No HEP

Here's my question: 1. One ID specialist speculated based on my initial numbers that I was positive 3-4 years prior to my diagnosis in 11/ 2011. Do you agree? 2. If that's the case, how much damage do you think was done to my immune system (considering initial CD4 = 374) and what effect would this have on my life expectancy. All of my other blood work is within range. My BP tends to be somewhat high averaging around 157/95. 3. Is there a way to spot lymphoma ahead of time from regular blood testing. Are there markers to look for that might indicate a developing lymphoma? Thanks again, Ron

Response from Dr. McGowan

Dear Ron,

Thanks for the compliment.

Regarding your questions:

1) 3-4 years, or maybe a bit longer is a reasonable estimate for how long you might have been infected before diagnosis. The height of the viral load is one of the most important factors driving the rate of progression. Your viral load was about average (not particularly high or low). and your CD4 count was not very low, so a few years is reasonable.

2) A few studies have shown that getting your CD4 count above 500 is a good goal to aim for following treatment. If you can maintain a CD4 count above 500 for 5 years or more, your risk of dying early may be eliminated. People over age 50 have a harder time reaching that goal, so it is good that you were tested and started on treatment soon enough to rebound quickly.

3)Unfortunately there are no good screening blood tests for lymphoma. Sometimes we will see a sudden drop in the CD4 count despite the viral load being suppressed (by this I mean a significant drop, much more than the usual fluctuations we see).

Best, Joe



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