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Two small bumps right under and behind my earlobes.
Aug 29, 2013

Dr. Young. Hello... I had a question regarding these two little bumps underneath my earlobes. Directly underneath. Even though the last time labs were drawn. The result was undetectable, I'm concerned this may be cause for worriment. By the way. What exactly does is mean to be undetectable? Other than lowering the risk of transmission and the amount of the virus itself being small? Does that mean you're deemed healthy and complications are less likely to happen to you. I would think that you're screwed either way. Even if you are undetectable. The medicines themselves can cause cancer and a whole slew of health issues can they not. I'm just concerned that even though you may be undetectable, ba things can happen regardless. Such as cancer or tuburculosis. Going blind and etc. Any insight would be greatly appreciated.

Response from Dr. Young

Hello and thanks for posting.

There's a lot in your question that deserves comment.

First off, being on treatment and having an undetectable HIV viral load doesn't mean you're "screwed". It means the opposite- it means that you've successfully accessed care, gotten on treatment for the virus (you've not mentioned any side effects, so I'll assume that) and are adherent enough to lower the virus to undetectable levels. Doing so has been shown to dramatically (did I say dramatically) reduce your risk of HIV-related complications and death- so much so that the most recent analyses from researchers in North America and Europe are now predicting that on average, people in your situation should have normal life expectancy.

Normal. Not going blind, or a slew of health issues.

If you were diagnosed with advanced HIV/AIDS with complications, it may take time for these to be treated; many conditions related to AIDS, such as blindness or cancer may leave permanent problems too.

None of this mean that having HIV is a good thing, nor is having an undetectable viral load proof that everyday is easy. There are many things that we need to be mindful of, especially preventive medical care and mental health if we are to strive for healthy aging with HIV.

Undetectable viral load means that HIV isn't found in your blood, and therefore likely not reproducing in your body. This means that your medications are working well, and your immune system is recovering (or recovered) from the injury caused by HIV. Being undetectable means that your much less likely to experience complications of HIV/AIDS and less likely to transmit the virus to others. Being undetectable is a first step in living healthy with HIV. Yet, there are other things that I'd include in this measurement- like what is the status of your immune system (CD4 count), mental health, food/water/housing/financial security- just to name a few.

Now, as for the small bumps under your ear lobes... these are in the location of lymph nodes. Having palpable lymph nodes is not uncommon among people living with HIV, especially those who have relatively recently started on medications. While your description does not sound alarming to me in any way, it would be reasonable to mention your symptoms to your medical provider the next time you see him or her. This reminds me to suggest working on cultivating a strong, trusting and non-judgmental relationship with your care providers-- having this should strengthen your health plan and any feelings of uncertainty about your health.

I hope that's helpful. Write back anytime. BY

CD4 increases and aging

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