Jun 27, 2007
Thanks again, again.for all the great work here!!
I decided to start meds in May 11th of this year with a VL 30,000 cd4% 362 and cd4% 15 (Sustiva 600mg and Epzicom 600mg) once a day. When I started meds I was sick with the flu and had a small fever 99-100. My doc said it was ok to start anyway. My flu seemed to clear up after about 3 days and my fever cleared. About a week after starting meds I developed a fever again with coughing. After an X-ray it was determined that I had right lower lobe pneumonia. After a week on Avelox the fever cleared and I felt much better.
On June 21st I got my latest results after starting meds, VL: Undetectable, cd4 688, and cd4% 25. The drugs seemed to work wonders in a month!! However I still have a productive cough with phlegm and Im constantly blowing it out of my nose, its mostly yellowishnever bloody. I run a couple of miles a day have no fever and my energy level is good. Also on June 22 I developed an outbreak of Herpes on my lower lip which I have always been able to control very well with a dose of Acyclovir when I felt it coming on. However Ive been on Acyclovir 800mg per day for the last 3 months per my docs advice as a preventative measure to keep the Herpes virus in check.
My doc didnt seem to be too concerned about my cough and phlegm. Q. Could I still be recovering from pneumonia? Before my next visit in late August I will be taking another X-ray per his orders Also, I thought it was strange to have a Herpes outbreak because Im already taking Acyclovir 800mg once a day for the last 3 months. Could this all just be my immune system coming back quickly? Are my latest results that look great unusual? Should I worry about Immune Reconstitution Syndrome? Will this Herpes outbreak endanger my great results? And, if I do have IRS will my body eventually adjust? Whew?? Ok Im done.
| Response from Dr. Henry
Your excellent surrogate marker (CD4 and viral load) response to therapy demonstrate that your HIV regimen worked very well in the precense of a concurrent illness (bronchopenumonia) and a herpes flare. Those conditions as you experienced are not generally linked to immune reconstitution syndrome. It can take a while to clear phlegm production after a pneumonia but clinical follow-up is recommended when symptoms persist. The herpes outbreak should not threaten your response to treatment. KH
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