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Exposure to AIDS in 7 months
Mar 7, 2005

I'm concerned that people don't seem to believe that HIV can be very aggressive. I became infected on Aug. 5, 2003 in a hospital in Jakarta, Indonesia while being treated for injuries suffered in a terriost bomb attack. I discoved I was HIV positive in mid-January. My CD4 was 724 which I was told was "robust" and I planned to do everything possible to stay healthy and build up my immune system in the "10 years" I had before it went to AIDS. Four weeks later my CD4 had dropped to 466. My doctor said that was impossible so he brought me in for another test. In 2 weeks time, my CD4 dropped to 141! I was immediately put on an aggressive regimen of Kaletra, Zerit, Sustiva and Epivir. Fortunately, it turned out that my virus is not drug resistant at all and the drugs immediately knocked down the virus and allowed my CD4 to rebuild to a recent test of 673.

Please assure people that HIV can be extremely aggressive and that they should take the warnings from NYC seriously!

(I am a 55 year old, happily married woman who has never used illegal drugs and is otherwise the picture of health.)

Response from Dr. Frascino

Hello,

Thank you for your post. From the number of questions I have received since the first release of the information pertaining to a NYC case of recently acquired multi-drug resistant HIV that progressed rapidly to full-blown AIDS, it seems many people are indeed taking the threat very seriously. I have discussed what we know about that case in several previously posted questions; consequently, I won't reiterate those comments again, other than to say that the threat of being infected with a strain of HIV that is already resistant to one or more classes of anti-HIV drugs is indeed real. And the possibility that someone who has been recently infected with HIV could be a rapid progressor is also real. We are still evaluating the underlying mechanisms involved in this unfortunate situation. These mechanisms involve particularities of both the host (a person's immune response to infections) and the virus (different strains can more easily gain access to CD4 cells and cause more rapid damage to the immune system).

That your viral strain is not resistant to antiretrovirals and that your immune system recovered rapidly after beginning you r aggressive regimen of Kaletra, Zerit, Sustiva and Epivir are encouraging. I'm also encouraged to see HIV/AIDS articles appearing once again on the front pages of important newspapers, even if much of the "panic" related to this particular case may not yet be scientifically warranted. What is certainly warranted is the realization that HIV/AIDS in general is not a distant threat, but rather a clear and present danger, resulting in the deaths of over 8000 people per day. Let's hope our current heightened awareness of the severity and threat of the AIDS pandemic does not soon lapse back into complacency and apathy.

I hope you will continue to do well with your treatment. We're here if you need us!

Stay well,

Dr. Bob



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