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What to Expect?
Nov 2, 2010

Hi Dr. Bob and thank you in advance for your time and service you provide. I'm a 53 year old male who contracted HIV about two and a half years ago. My numbers are in the very upper norm range currently and not on meds. My question is probably what everyone's is and the reason we frequently visit The Body site as well as Google this and that. What to Expect as the disease progresses? I feel I have educated myself and understand the basics, but get conflicting stories and info regarding living with HIV. Some say it is simply a manageable disease and you lead a normal life. Others dispute this and make it sound pretty much an all consuming part of life. Even you yourself have mentioned it a "struggle" at times in your own life. I'm really seeking understanding of what to expect not only because it is simply my nature, but because shortly after infection I developed autoimmune symptoms (connective tissue disease) which have continued to be bothersome. I didn't expect this since after diagnoises my first labs were very encouraging (cd4 1605/52%). My doctor doesn't seem to address these autoimmune issues I'm having since they are not currently overly significant other than he did prescribe medication for the IBS so I could have bowel movements. I'm find myself becomming increasingly depressed along with anxiety because in the beginning with such great labs I thought I would be fine for a long period of time. Any insight from you as to what to expect would be so appreciated. I just need to know. Thank you.

Response from Dr. Frascino

Hi,

Unfortunately none of us has an infallible crystal ball that allows us to accurately see into the future. HIV/AIDS is an extremely variable disease from individual to individual, due to many factors, including both the specific virus acquired (viral strain) and the body's immune system's response to the invader. Some folks mount a much stronger and more durable immune response than others. There are other HIV-associated conditions that come into play as well (cardiac events, non-AIDS-defining cancers, etc.). We are learning more about chronic HIV inflammation and its possible connection to advanced aging in HIVers. Antiretroviral medications also complicate the situation due to side effects and toxicity. However, there is no doubt antiretrovirals have had a dramatic impact on HIV morbidity and mortality.

And so the answer is no one knows. Then again, even without HIV, no one really knows what tomorrow will bring, right? HIV/AIDS is in general a very slowly progressive and ultimately fatal condition. With the improvements made in treatment, we are hopeful that some of us will die of old age rather than of AIDS!

If you are having difficulty with anxiety and depression (both of which are extremely common or HIVers), I would suggest you talk to your HIV specialist physician. Anti-anxiety and antidepressant medications as well as counseling (psychotherapy) may be very helpful. I would also encourage you to read the testimonials and blogs on this site for a personal perspective from those of us who have been cohabitating with HIV for many years. Don't let HIV spoil your life, happiness, health or future plans!

Dr. Bob



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