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CD4 count and treatment, finesteride and life expectancy
Aug 10, 2007

Docotors:

You guys are a blessing. I have been recently diagnosed as HIV positive - totally out of the blue. I don't use drugs and have never had unproteted sex. I still cannot believe, and am having a hard time coming to terms with the news.

I have a few questions. Please keep in mind that it has been only two days since getting the news - I have tried to read as much as I can but am still confused and, frankly, terrified.

1. Why wait until your CD4 counts drops below 350 to take medication. Why not start right away?

2. I am takin gfinesteride to prevent hair loss. I understand that low testosterone levels can put me at risk - should I stop taking the medication? Any other medication out there that has the same effect as finesteride?

3. How long should I expect to live a healthy life? I know the situation varies from case to case, but I tested negative 6 months ago and am confident that they have caught the disease at an early stage (although I don't have the results of my blood test yet). Are you hopeful that future medication will allow me to live as long as the average person?

Thanks, and I appreciate your time.

Response from Dr. Henry

The chances to become ill from an AIDS-related problem over the short term are generaly low if the CD4 count is > 350. There is likely some modest overall health benefit if antiretroviral therapy is started at higher CD4 cells but that needs to be further worked out since therapy is costly and resources are limited. Connecting with a good HIV specialist and following your blood test results over a period of time (to produce your own individual trend) are crucial elements to optimize your treatment. The prognosis for HIV+ persons with access to good health care is good (> 20-30 years in some recent studies) and continues to get better. Persons doing well on treatment wth CD4 counts > 500 may have health outcomes increasingly similar to the HIV- population but more studies are needed and effective therapy has only been available for 11 years. KH



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