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regular donor
Nov 11, 2006

Hi Bob,

After an exposure in sep 05, I had ARS symptoms, And then I had series of medical probs including brain surgery (neurocysticercosis), (I have never been sick before). Then I had series of health issues common in hiv positive population (acne, seborrhea, 3 months cont diarhhea, low wbc, tiredness).

I had multiple elisa, and wb negative upto an year. But my cd4 counts were suggestive of hiv also. @ 6 wks after exp : 416 @ 3 months : 580 @ 6 motnhs : 506 @ 9 months: 449 @ 12 months : 395 And I am getting more and more sick now. cd4/cd8 ratio has been between 0.8-to 1.0.

I have been a regular donor at your site. I have tried to follow your advice and not think I have hiv. But my cd4 counts and my persisting health conditions are worrying me. Do I have a rare strain of hiv or some other viral immunodeficiency ? Please reply back as I have no clue of whats going on.

Response from Dr. Frascino

Hello,

There is no doubt you have had some significant health problems over the past year, including neurocysticercosis. However, it is important for you to realize these health problems are not related to HIV. Your "multiple negative ELISA and WB" tests up to one year are definitive and conclusive that you are HIV negative. HIV is not your problem. No way. No how.

Regarding your CD4 counts, what is important to realize is that CD4 cells are involved in a wide spectrum of immune responses. They are not exclusively related to HIV. CD4 cell counts vary significantly up and down due to many non-HIV-related factors. It is true your CD4 counts primarily in the 400-500-cell-count range and CD4/CD8 ratios between 0.8 to 1.0 are mildly depressed. The "normal" ratio is generally closer to 2.0. This abnormality, however, is not HIV related, as you have irrefutable evidence that you are not HIV infected. My advice would be for you to consult with a clinical immunologist and/or infectious diseases specialist for further evaluation. Depending on where you live, you could consider having a second-opinion evaluation at a medical center. I have evaluated a number of cases similar to yours at both Stanford Medical Center and University of California San Francisco Medical Center. Most medical centers (associated with a medical school) are well equipped to perform these types of evaluations. Keep us posted. I'll try to assist any way I can.

Good luck.

Dr. Bob



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