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Prognosis: HIV, Tiny CD4 Count, Severe Pneumonia (Editor's Pick)

Jul 5, 2015

A friend of mine was recently diagnosed with PCP with CD4 count < 10. He's currently very ill, on ventilators. What are the chances that, under his current condition, he will be able to get rid of PCP. Also, does this likely to imply that he didn't know his hiv status (impossible he didn't take any medication if he knows about it)?

Response from Dr. Young

Hello and thanks for posting.

Sorry to learn about your friend- he is quite ill indeed, the victim of late HIV diagnosis (or entry into care) and pneumocystis pneumonia. While is prognosis is guarded, Pneumocystis does respond to readily to antibiotic treatment (trimethoprim-sulfa is the drug of choice). Th main issue will be the recovery of his lungs from the injury. This happens in the majority of people with PCP, but in some can be very serious and life threatening.

The other key issue is the urgent need to have him started on HIV treatment. There is compelling evidence (and treatment guidelines reinforce) that starting treatment as soon as possible reduces the burden of disease and death.

I hope that's helpful. Please feel free to write back anytime and here's hoping for your friend's rapid and complete recovery. BY



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