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Scared Single Dad (Again)
May 19, 2008

Dr. Bob,

After 4 months since being diagnosed I finally have news to share that I just learned today. My CD4 Count is at 13, and my VL is over 300,000 so Im a little spooked at the moment. The good news: My Hepatitis tests came back negative, they said there was nothing to indicate that I should be concerned about TB, they are putting me on Atripla because I show no drug resistance of any kind. In addition to Atripla, Im being put on two generic drugs until my CD4 count rises back above 200. Ive asked two doctors this and I value your opinion. My son is my biggest priority, should I cancel my 401k and jack my life insurance up? The two doctors dont seemed that concerned over this and provided I dont have any serious adverse side effects I should be fine in a month or two. What are you thoughts am I a typical case?

Thanks

Lewis (Scared Single Dad)

Response from Dr. Frascino

Hi Lewis,

No doubt your numbers are alarming and require immediate intervention. The two generic drugs are most likely antibiotics used as prophylaxis to decrease your chances of getting an opportunistic infection. (Bactrim for PCP prophylaxis, for example.) I agree Atripla should be a good choice for your first regimen. It's potent, convenient and reasonably well tolerated.

Regarding jacking up your life insurance, I doubt that is an option considering you now have an AIDS diagnosis. As for what the future holds, obviously no one knows. Unfortunately when it comes to HIV/AIDS there is no such thing as a typical case! What will be important is your virologic (HIV plasma viral load) and immunologic (CD4 cell count) response to antiretroviral therapy. If your viral load plummets and CD4 count begins to rise, that's great news. Hopefully your viral load will decline to undetectable levels and your CD4 count will rise well above 200. This would decrease your risk of opportunistic infections. Close aggressive follow-up and management of your HIV/AIDS is critical. Remember to take your meds as directed. We'll all keep a very optimistic attitude.

Good luck. I'm here if you need me.

Dr. Bob



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