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please give me some suggestion!
Dec 29, 2008

Dear doctor, i am chinese.my husband and i were diagnosed positive in Aug this year.the first time,my cd4 is 228 and he's 340.after 3 months,i am still 226,but his decrease rapidly,just 140.now his CD4 already became 80 and my is 240 in the tird test of 2 week ago.by the way,he has been infected for about 8 years.maybe i was positive in 2 years ago.so i have 3questions here. 1¡do i need to take medicine now?(i feel my cd4 is steady,so......) 2¡because the medicine isn't enough for all people who need to cure in China now.so my husband can't get medicine now.i am scared there some illness happening to him.so whould you give him some useful suggestions about keeping health untill he get meds. 3¡the doctor suggest us to take stocrin+zidovudine+lamivudine.i don't know whether they are perfect for us. please give us a help!!

Response from Dr. McGowan

I understand your feeling of frustration. CD4 counts are the best guide for the time to start HIV treatment. It is best to start medication when the CD4 count is above 200 (in the US the recommendation is to start at 350 cells). So, your husband has a need for medication now and you would benefit as well to maintain your health. CD4 counts can vary greatly from one reading to the next but the trend downwards in the past few months for your husbands counts is a sign that he should be on treatment as soon as possible. It might also be an indication that he may have an opportunistic infection (like pneumonia from PCP or tubeerculosis). If he has had fever, sweats, weight loss, diarrhea, cough these should be looked into. While waiting for HIV medication he should take medication to prevent opportunistic infections, such as trimethoprim-sulfamethoxazole and should be screened for tuberculosis. Also try to keep a balanced diet, especially one rich in green vegetables. He should avoid undercooked meats and should drink bottled or boiled water. He should only eat fruits that he (or you) have peeled yourselves. He should be vaccinated for influenza, hepatitis and pneumonia. The choice of anti-virals suggested by your doctor sounds reasonable. It is unlikely that there would be drug resistant HIV where you live. I wish you and your husband the best of luck in getting the treatment you need as soon as possible.

Joe


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