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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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The CMV Connection
Feb 8, 2005

Hi, Dr. I recently reached undetectable VL after six months on Sustiva-Viread-Epivir, having started treatment with a very high VL (860,000). Today I read a Reuters article about a study in the Lancet entitled: "CMV positivity still tied to HIV progression in HAART era", the thrust of which is that "CMV positivity during follow-up was associated with a 2.2-fold increased risk of progression to a new AIDS-defining disorder (p = 0.005) and with a 4.1-fold increased risk of death (p = 0.0002)." I remember my first bloodwork revealing that I'm also CMV positive, and I recall asking a nurse about it and being told that most people have CMV and that I shouldn't worry about it. Now I'm wondering how this new information might affect my prognosis for remaining undetectable and healthy in the future. Any insights would be appreciated. Best, D

Response from Dr. Conway

I am pleased that you are responding so well to such a simple therapy. You do not mention your CD4 count, as this is very important to understanding the article in the Lancet. All of the patients had, in the past, a CD4 count below 100. In addition, they defined "CMV positivity" as having the virus growing in their blood, not jsut being CMV positive by standard antibody testing. I suspect that it is the antibody test you refer to when you mention that you were CMV positive, as are msot people.

So...unless your CD4 count has been < 100 (especially in the recent past) and your test for CMV viremia (not just antibody) is positive, this article does not apply to you.

Could Sustiva Viramune class be causing lipo issues?
hives and rash

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