SHINGLES AND CD4 COUNT.

Question

Hello There, Doctor. I have developed a case of shingles since 7 days ago with the typical burning sensation, etc.. I got the skin lesions on my left arm and my Dr. prescribed 1 mg of acyclovir twice daily and cream on the lesions. My last labs showed a cd4 count of 303 (2 yrs ago it was 115), and < 50 copies VL. Now, my doubts are these:

  1. My Dr. seemed baffled by the fact that I had developed shingles with the lab results above mentioned, is there a reason for that (her being baffled)?

  2. I had started on some herbalife product with taurine-caffeine-guarana since I have experienced intense fatigue since a year ago. Could that have messed up my immune system?

  3. Although the lesions are located on my left arm, I am experiencing intense muscular-like pain on my body (torso), as if a flock of blond tanned muscular enraged men have beaten me with baseball bats, then they suddenly drop their bats and grab their... sorry, I just got carried away.

I'm waiting for your always kind answer (and the blond tanned musc... sorry).

Richard.

Answer

Hey Richard,

Sorry to hear about your recent case of shingles. OUCHAMAGOUCHA! They can be damn annoying and uncomfortable. Responding to your specific questions:

  1. You want me to explain why your doctor seemed baffled? Hmm. That would be difficult, as I really have no idea. Shingles outbreaks are certainly not uncommon. I doubt your episode had much to do with your HIV/AIDS, as your counts are reasonable and viral load, undetectable. Shingles outbreaks limited to one side of the body and one specific area ("dermatome") are the "usual" type. In patients with deficient immune systems, shingles often is much more extensive (beyond era single isolated dermatome) and difficult to treat. So, I see no reasons for bafflement!

  2. Your Herbalife product would not mess up your immune system or cause shingles. The caffeine and caffeine-like components in your supplement could perk you up a bit, but no more than a double espresso, which I personally find much more enjoyable than popping overpriced herbal supplements.

  1. Have your doctor check out the area of discomfort to be certain it corresponds to a single dermatome (area innervated by a single nerve root). As for the blond, tanned, muscular men, don't leave us hanging. Finish the story!!!

Feel better Richard.

Dr. Bob