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elective surgery/initial treatment/having children
Nov 20, 2003

I broke my nose rather badly few years back and was planning on having sme reconstructive surgery done in the next 6 months or so to remedy the situation... I was diagnosed HIV positive one week ago.. my previous test was negative, about 5 months ago, meaning i contracted it recently.. i am asymptomatic, no viral load, tcells normal..what does this mean for my chances of surgery? is it possible to schedule an operation without revealing my hiv status? or will the doctor routinely check first? and does the fact that i just contracted HIV make it more or less probable that a physician will be willing to undertake my case? also, my doctor wants to put me on an aggressive combivir/viramune regimin for 6 months, thinking that it might yield better long term results than waiting until t cell levels drop/viral load increases... do you think this is a good idea,or if unable to proffer advice, how common is this and how effective? it doesn't seem to be the recommended therapy of the US Dept of health and Human services - they advise no treatment until either my tcells drop or viral load surpasses 50,000.. and if i agree to this 6 month inital therapy, can i have the elective procedure done during this time, or should i wait until the course of treatment is completed? finally, what does my HIV status mean for my chances of ever safely fathering my own children (not passing infection to mother or child)? is there any sort of laboratory procedure that might extract uninfected sperm for artificial insemination, or something like that? thank you

Response from Dr. Henry

The optimal time to start HIV treatment in recently infected persons is not known so no sweeping generalization is appropriate. Starting treatment early generally does not preserve much anti-HIV immunity. Elective surgery generally goes well in HIV infected persons. It is an expected courtesy for a patient to tell his doctor and surgeons about his/her HIV status and may benefit the patient themselves if problems develop. HIV+ men are increasingly safely fathering children often under medical supervision I (on HIV meds, sperm washing, etc). KH



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