Dr. Bob, Not a question, but a report of good progress. In September I wrote to you and asked how to help my brother recover from severe fatigue that he was having. He was newly diagnosed and had had PCP and shingles and had a very low CD4 (<50). You thought that the cards were stacked against him. I was kind of surprised to see you say that since you are generally very "positive". He started on Atripla in September and as of Dec. his CD4 is up to 200 and his viral load is undetectable. For anyone who is looking for some hope, I think that his case shows just that. He has returned to school and is continuing with his life. I appreciate all your information that you provide on this site and hope you have a great 2011.



Excellent news! I'm absolutely delighted! Remember I did say "It is possible that your brother will improve if his infections are treatable and if he responds well to antiretroviral therapy". (See below) And that is exactly what happened. Unfortunately, not everyone is so lucky! Thanks for taking the time to write back and update us on this extremely encouraging story. I'm confident it will help others who find themselves in similar dire straits.

Please give your brother a hug from all of us and let him know he has our best wishes for continued improvement!

Dr. Bob

Not on meds yet but very fatigued Sep 26, 2010

My brother was recently diagnosed HIV + and a series of infections has prevented his start on HIV meds. He is extremely fatigued and his CD4 is around 50. Is this just the result of HIV or could there be another cause. We are hoping that he can start meds within two weeks.

	Response from Dr. Frascino


There are many potential reasons for your brother's fatigue, including the "series of infections," his very advanced-stage AIDS, hormonal imbalances, anemia, and psychological stress regarding recent AIDS diagnosis.

Your brother's case is another tragic example of HIV/AIDS not being diagnosed and treated in a timely fashion. Chances are your brother has been HIV infected for at least 7 to 10 years. Had he been diagnosed and treated earlier, his immune system would not be so decimated and he would not have the opportunistic infections resulting from his severe immunodeficiency. It is possible that your brother will improve if his infections are treatable and if he responds well to antiretroviral therapy. However, his very late diagnosis has certainly stacked the cards against him.

Dr. Bob