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39Yrs old African Male,tested positive one year ago
Feb 29, 2004

I was tested positive one year ago and my cd4 count was 330,one year later after the last test which is just few weeks ago my cd4 has drop to 230. I have been having night fever and my doctor still insist not to start any treatment until my cd4 gets below 200.Is her procedure ok? because this night fever does not subside dispite all the treatment i have taken.I do not perform my duties,because i fill very weak in the morning. It all started as a maleria fever. With a cd4 of 230 how much time can i withstand with treatment. JOE

Response from Dr. Frascino

Hello Joe,

I would strongly disagree with your doctor's advice. Is she an HIV specialist? If not, you need to see one as soon as possible. If she is, consider changing or, at least, getting a second opinion. True, some guidelines state you can wait until the CD4 count drops to 200 to begin antiretroviral medications; however, that's assuming you have not had symptoms. You are significantly fatigued and having fevers. CD4 counts vary quite a bit from day to day, and even during the same day. Consequently, your 230 may indeed be 250 (less worrisome) or 200 (very worrisome). I would definitely encourage beginning anti-HIV therapy now. If your counts fall below 200, you would be at a much higher risk for developing opportunistic infections, such as PCP. I would also begin a thorough workup to evaluate your fevers and fatigue. It's possible you could have a very treatable condition, such as an unrecognized infection (fevers) or anemia (fatigue).

Joe, do not sit back and wait to become more ill. Demand the evaluation and treatment you deserve now!

Good luck. Let me know if there is anything else I can do for you.

Dr. Bob



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