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Time to wake up Dr. Bob!
Dec 27, 2005

Dr. Bob,

Something's wrong with the world today and you have to help us figure out what it is.

All of these countless people who are normally healthy individuals yet experience every symptoms of HIV which is in the book can't be wrong. I know that you say symptoms don't equal the disease, but I am convinced that there is something out there very similar to HIV that is causing people to be sick despite repeated negative HIV tests.

If someone is relatively healthy for 29 years and all of a sudden they get a debilitating illness that does not go away after a risky sexual encounter, what explanation can you give them after they test negative for HIV?

Can you share your thoughts on ICL or other illnesses similar to HIV? I know you don't want to cause panic, but the people have a right to know!

Response from Dr. Frascino

Hello,

Time to wake up??? What???.....I can assure you my Peet's coffee double expresso has definitely kicked in.

You ask, "If someone is relatively healthy for 29 years and all of a sudden they get a debilitating illness that does not go away after a risky sexual encounter, what explanation can you give them after they test negative for HIV"? The answer is quite simple. What I tell them is that "whatever is causing your symptoms, it's not HIV."

Regarding ICL, I've addressed this topic several times, so rather than reiterate the information again; I'll repost a question and response from the archives.

Finally, if you have persistent symptoms and have ruled out HIV, see your doctor for an evaluation. Stop chasing a disease you do not have.

Good luck.

Dr. Bob

THIS IS NOT IN THE ARCHIVES!! Nov 17, 2005

Youve ignored this before and im asking again because i know its not in the archives. Simple question! Can someone have symptoms of HIV infection and then develop ICL? or is ICL independent of HIV like symptoms?

Response from Dr. Frascino

Hello,

O.K., here's the scoop on what we know about Idiopathic CD4 Lymphocytopenia (ICL). By definition, it's a syndrome characterized by low CD4 counts (less than 300) that are not caused by HIV or other medical conditions (Sjogrens Syndrome, Sarcoid, Radiation therapy, atopic dermatitis, steroid therapy or lymphoma). Transient unexplained decreases in CD4s can occur in healthy folks. Several important observations have been made about ICL:

1. There is no evidence it is caused by an infectious agent, as there is no clustering or evidence of spread from contact evaluations.

2. The most common opportunistic infections associated with ICL are cryptococcosis, molluscum and histoplasmosis. In general, folks with ICL have fewer OIs than HIV/AIDS patients for any given CD4 level. Infections, such as PCP, Candida and KS (HHV-8), are unusual for ICL.

3. ICL patients generally have a relatively good prognosis and their CD4 counts remain stable.Presently ICL is being treated with IL-2 and gamma interferon, but since cases are relatively rare, treatment experience is limited. Cases of ICL should be reported to local and/or state health departments for follow-up.

That may be more information than you or our readers wanted to know, but at least you won't accuse me of ignoring you any longer, right?

Dr. Bob



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