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THis may be an odd question

Aug 16, 2004

Dr. Bob,

I always practice safe sex and about 1 year ago, while having anal sex,(I was receptive this time) the condom broke. The other guy was negative, but he gave me syphilis. It was not until a scheduled Dr's appt that I found out, and it was somewhat advanced according to the Doctor. The exposure was 4 months old. The other guy was treated when I called him. Fortuantely, I had not been sexually active with others myself during this time, I have been tested regularly since getting 3 sets of penicillan and all is well in that department. My questins is that my t-cells dropped during this period as well as my viral load went up to over 300. My doctor switched me to sustiva. The VL is now down to just under 60 and my t cells are just starting to come back up. They dropped from 500 to 225 and are now 275. Could this have all been caused or exacerbated by this std? Thank you.

Response from Dr. Frascino


Yes, it is possible. Any concurrent infection can raise the HIV viral load. As the viral load goes up, T-cells can come down. The good news is that your syphilis infection has now been diagnosed and adequately treated. Your HIV viral load is heading back toward undetectable levels and T-cells are once again on the rise.

Certainly there can be other causes for rising viral loads and declining T-cells, such as the development of antiretroviral drug resistance, poor adherence to dosing schedules, negative drug-drug interactions, etc. Hopefully, your HIV specialist has looked into those possibilities as well.

For now, it appears that from both virologic (HIV viral load) and immunologic (T-cell counts) standpoints, you are heading in the right direction! I'd follow your T-cell count and viral load closely for awhile to make sure this good trend continues.

Good luck.

Dr. Bob

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