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Regarding your 2-13-15 response on OTC pain meds
Feb 23, 2015

I am confused as I have always been told to avoid acetominophen becaue of potential liver damage/issues, NO? I do take them sporadically, but my ID doctor will prescribe me Naproxen if I ask for some. (On ATRIPLA, ITRACONAZOLE, DAPSONE,GABAPENTIN) Last labs: VRL <20 CD4 230 CD4% 14 ALL OTHER LABS GOOD. Have not been able to breakaway from 200's since I first reached it several years ago. Diagnosed in 2008 when I presented with PCP, Disiminated Histo and MAC. CD4 was 6 which brings me to another question? I've read similar accounts here whereas when someones nadir CD4 is low like mine was, then it it seems to take a long, long time for the CD4 count to go back to the so-called normal range of 500-1500 if it does at all. Do we know why yet and does it matter in that since my intial diagnosis, knock on wood, I have yet to contract another oppurtunistic infection.

Response from Dr. Young

Hello and thanks for posting again.

Actually, no. As long as you don't have active liver problems (like viral hepatitis), occasional acetaminophen, taken as instructed, is actually quite safe. Even non-steroidals are safe, if you don't have underlying kidney problems and taken sporadically. I tend to favor the former for minor issues, especially among people taking other medications (like tenofovir) that can cause kidney problems.

As for CD4 count recovery and health, you're right. People who initiate HIV care and treatment (like you) with very low CD4 counts take longer to recover their counts, and are at greater risk of not reaching fully normal levels. Having said that, with regard to OIs, in large population studies (like our CDC-sponsored HOPS cohort), OIs are very rarely seen in people on HIV medications with undetectable viral loads and CD4 counts above 200 (really, even above 100). This indicates that keeping HIV at bay, even if the counts are still low matters. Moreover, what matters less is a number and what matters more is your health and quality of life.

Touch wood for good, long-term health. BY


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