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V Imp .. Please Answer
Dec 9, 1999

Dear Doc ,

I have tested positive six months ago (june 16)( am asymptomatic since then

Had my CD4 results in the last week & they are 875 .

My doc tells me that typically it would be 6-7 years for me from now to have good quality with no meds . What it means is that my cd4 will drop from 900 - 300 ( by 600 )

in about 6 years at a rate of 100 CD4 / year . Does this rate seem realistic to you and do you think i can look forward to continuing my post graduate studies which I am pursuing ( 2year MD Medicine ). Also do you think it is safe for me on the same account that my CD4 are good & my exposure to more infection ( Oppurtunistic or otherwise) my not be possible even though I may be working in hospital environment with some amount of invasive procedures which include handling of body fluids.Please answer because i am desperately looking forward to your answer

A.S

Response from Dr. Pavia

Dear A.S.

Your CD4 count is very normal at this point. I can't tell you how fast it will drop, that ranges from as little as 10 cells/year to up to 200 and is very variable from one person to the next. If your doctor knows much about HIV, s/he will have also checked an HIV viral load. The viral load is a pretty good predictor of how fast the CD4 count will drop-the lower the viral load, the slower the change.

However, you need to remember that even before good drugs, the average person took 10 to 11 years to progress to the point at which we would call it AIDS. Now, with good treatment, a lot of work on your part, and a little luck, you may live out a normal life span, although we don't know that for sure. Plan to live your life the best way possible, and don't put off your dreams because of the diagnosis.

There are some issues to worry about for a doctor or health care worker with HIV, including TB, but it has not stopped many from continuing to work in medicine.

Make sure you are learning as much as you can about HIV. If you are studying medicine, go to the journals. They are not quite as up to date as the net, but a little more reliable. Make sure you connect with the right doctor, someone you like who really knows HIV. And who knows, maybe when you finish your studies, you'll help find the cure.

ATP



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