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How does AIDS affect SLE (lupus)?
Aug 10, 2001

Hi. I was diagnosed with SLE (lupus) in 1990, and with AIDS in 2000. My initial T-cell count was 26, viral load 600,000. Unfortunately, I had been taking Methotrexate for years to suppress my immune system and help with my lupus. I have developed resistance to my first attempts at treatment after a year due to excessive vomiting, and am now taking, Zerit, Sustiva, Videx and Hydroxyurea.

I would like to know more about how AIDS affects my lupus. Since lupus requires an immune system to become overactive, and basically I don't have one, will most symptoms of lupus let up? My rheumatologist said some will, but I am experiencing great increases in fibromyalgia and arthritis pain levels. What should I expect?

Also, I want to know if doctors who prescribe drugs to suppress immune system function are required or encouraged to ask the patient to take an HIV test first... I wish I would have been. I had so little risk and all my symptoms could be explained away by lupus and the effects of the Methotrexate.

Thanks!

Response from Dr. Fisher

SLE is a fairly rare disease; I have never seen it in a person with HIV. I agree that some interaction between the two is likely. And I can't imagine anything beneficial arising from the presence of HIV in a person with SLE. Can you get off the HU? I would be concerned about suppressing your WBC especially with methotrexate. And most of us don't think that HU is very effective as a component of antiretroviral therapy. Your comments about doing an HIV test are appropriate, but I bet it is rarely done in the absence of obvious risks. AF


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