Dear Dr. Horwarth:

I am a 41 year old male; diagnosed HIV+ in 2003. My viral load is currently undetectable and I have a CD4 of 846 after taking Viramune and Combivir for the past 18 months. I have a very healthy lifestyle, including weight training 4x a week, eating, right, I don't smoke and I don't drink. I have been taking medication for depression since 1995 and was hospitalized briefly in December 2000 due to severe depression.

Now for my question... I feel like I have done everything I am supposed to do for my health in fighting HIV, but I feel like my long-term prognosis is still dismal. It's hard for me to think long-term in my life, let alone 2 to 5 years from now. As far as I can tell, I will probably live only til the age of 55 or 60 with a boatload of illnesses and infections along the way. It scares the hell out of me! What should I do? I was in therapy from 1998 to 2003 and took a break because I felt "therapied out" and just couldn't think of anything to say anymore in my mental health sessions. In addition, I am in a low-paying, low stress job and I'm afraid to leave it because I think a more stressful job would be very hard on my mental health and physical health, but for the past 8 years I have not been able to put any money toward my retirement -- if I even live long enough to collect it. Please help!

You have an excellent prognosis. You're healthy, and you have had a great response to Viramune and Combivir. You're doing the right things to take care of yourself.

There is no reason why you shouldn't continue to live a healthy life for a long time. With an undetectable viral load and CD4 count of 846, you have an extremely low risk of complications due to the direct effects of HIV or due to impaired immunity. If your medication is closely monitored, hopefully you will not suffer from any serious side effects. We cannot predict the future for you, but you have good reasons to have a positive outlook.