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Aids + hysterectomy + possible hormone therapy
Nov 27, 2004

I am full blown with a current cd4 of 29 - I am scheduled to have a total abdominal hysterectomy this week with a possible oopherectomy (removal of ovaries. Can you please advise me of the possible advantages and disadvantages or concerns of this surgery and also with adding a hormone therapy along with my meds schedule. I am currently taking Kaletra, Combivir, Diflucan, and Septra DS. I was on Zithromax for one month but they have just taken me off of that prescription. I have only know that I was positive for two months now so this is all very new to me. However I have been fighting female conditions for years. Thank You for your assistance.

Response from Dr. Lee

You did not explain why you are having this hysterectomy, so I am not really able to help explain the advantages. I would tell you that with a CD4 of only 29, any significant stress on your immune system (such as a major surgery) is serious and the potential for harm is much greater than for someone with a normally functioning immune system. Make sure your docs are well informed on HIV care, that you don't miss your antiretroviral meds because of the surgery (if at all possible) and that they are willing to use antibiotics liberally. If it is possible, I would recommend postponing the surgery for a few months until you can "grow" your CD4's better (since you've only been on treatment about two months). However, as I began- I don't know why you are having the hyster now. Perhaps the trade-off is important.

As far as your other meds- you may not need hormones if they leave even one of your ovaries. If you do need hormone replacement, it has few interactions, but your docs should review them for you.

Also,I would suggest that you be back on the Zithromax (1200mg weekly) in order to protect you from Mycobacterium Avium which is an opportunistic infection you are at risk of acquiring due to your very low CD4.

Be well.

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