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My Aunty Is HIV Positive From Last 7 Years.(since 2011).
Question: My aunty is HIV positive from last 7 years.(since 2011). She is now 63 years old.
Her CD4 count is always maintained at between 700 to 900 without any medicine. As we are checking for every 4 moths or 6 months. Doctors (HIV Specialist) also checking her regularly and saying she is ELITE CONTROLLER. She absolutely fine in all respects. They asked us to get some tests related to upcoming change of other complication against HIV. we got it done, all are fine.
But now they are saying to start ART. I am postponing every time, as she is fine with CD4 count from last seven years and with fear of side affects with ART. Medicine expenditure is not issue.
So Kindly suggest me what is best advice.
Her CD4 count is always maintained at between 700 to 900 without any medicine. As we are checking for every 4 moths or 6 months. Doctors (HIV Specialist) also checking her regularly and saying she is ELITE CONTROLLER. She absolutely fine in all respects. They asked us to get some tests related to upcoming change of other complication against HIV. we got it done, all are fine.
But now they are saying to start ART. I am postponing every time, as she is fine with CD4 count from last seven years and with fear of side affects with ART. Medicine expenditure is not issue.
So Kindly suggest me what is best advice.
Brief Answer:
It is wiser to start ART as early as possible.
Detailed Answer:
Hi, Welcome to 'Ask A Doctor' service.
Thanks for posting your query.
Your aunty's CD4 count is well maintained for 7 years. Many people develop HIV manifestations even after 10-12 years or more.
Now the present day guidelines for HIV management as per WHO or CDC, recommend treatment to all, irrespective of the CD4 count. These guidelines have arrived after a long experience and various studies.
When the virus is inside the body, naturally a lot of inflammatory processes are going on, which in turn affect the various systems of the body in many ways.
So it is better to start ART as soon as possible and protect her body from any irreversible changes.
Dr S Murugan.
It is wiser to start ART as early as possible.
Detailed Answer:
Hi, Welcome to 'Ask A Doctor' service.
Thanks for posting your query.
Your aunty's CD4 count is well maintained for 7 years. Many people develop HIV manifestations even after 10-12 years or more.
Now the present day guidelines for HIV management as per WHO or CDC, recommend treatment to all, irrespective of the CD4 count. These guidelines have arrived after a long experience and various studies.
When the virus is inside the body, naturally a lot of inflammatory processes are going on, which in turn affect the various systems of the body in many ways.
So it is better to start ART as soon as possible and protect her body from any irreversible changes.
Dr S Murugan.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dear Sir
thanks for your reply.
I am understanding with your reply is "she need to take ART after having CD4 count 900 also... this is to prevent problems due to inflammation in internal body. this inflammation can lead for other issues... am I right sir ?
what is the reason for inflammation ?
how it affects negatively in body ?
Are there any serious complications / side affects with present availble ART?
Is Her age (63 years) support for ART ?
For how long she can live with ART ? I mean how long it works ?
Please let me know what best ART available in XXXXXXX If price is not criteria.
Kindly educate me in these questions to take a proper decision on ART start. as once it is started, can't be stopped.
regards
thanks for your reply.
I am understanding with your reply is "she need to take ART after having CD4 count 900 also... this is to prevent problems due to inflammation in internal body. this inflammation can lead for other issues... am I right sir ?
what is the reason for inflammation ?
how it affects negatively in body ?
Are there any serious complications / side affects with present availble ART?
Is Her age (63 years) support for ART ?
For how long she can live with ART ? I mean how long it works ?
Please let me know what best ART available in XXXXXXX If price is not criteria.
Kindly educate me in these questions to take a proper decision on ART start. as once it is started, can't be stopped.
regards
Brief Answer:
ART has to be selected as the individual's need and health status.
Detailed Answer:
Hi,
Welcome back.
Exactly. You are correct in understanding the things. She has to put on ART whatever may be her CD4 count immaterial of her age.
Any foreign substance evokes an protective reaction and changes in the body which is called as inflammation. It can happen at all level at any type of tissue of our body. This can advance the degenerative changes of body due to age or in a normal person and they will reflect in cardiovascular system, joint system, excretory system and they are more prone to get cancers etc.
With the ART and proper followup along with few life style modifications one can live as long as an individual without HIV.
The cost of ART is not High nowadays. But the appropriate combination has to be selected according to various situations like age, conditions of other systems of the body etc. Good ART is available to patients through a HIV specialist as low as INR 1200 per month in XXXXXXX MRP may be high and doubled price.
Dr S.Murugan
ART has to be selected as the individual's need and health status.
Detailed Answer:
Hi,
Welcome back.
Exactly. You are correct in understanding the things. She has to put on ART whatever may be her CD4 count immaterial of her age.
Any foreign substance evokes an protective reaction and changes in the body which is called as inflammation. It can happen at all level at any type of tissue of our body. This can advance the degenerative changes of body due to age or in a normal person and they will reflect in cardiovascular system, joint system, excretory system and they are more prone to get cancers etc.
With the ART and proper followup along with few life style modifications one can live as long as an individual without HIV.
The cost of ART is not High nowadays. But the appropriate combination has to be selected according to various situations like age, conditions of other systems of the body etc. Good ART is available to patients through a HIV specialist as low as INR 1200 per month in XXXXXXX MRP may be high and doubled price.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir
Thank you very much for your reply.
Are there be any serious side effects with ART as per available data ?
we are not using ART for these many days with one reason, that is side affects fear only.
Thank you very much for your reply.
Are there be any serious side effects with ART as per available data ?
we are not using ART for these many days with one reason, that is side affects fear only.
Brief Answer:
Most of the ART drugs are well tolerated.
Detailed Answer:
Hi,
Welcome back.
There is no drug, other than water soluble vitamins (Vit. B and C), without any side effect. Your doctor, who prescribing modern medicine drugs for you, will be aware of these facts. He/she will examine you, investigate the blood parameters decides the drugs suits you and closely follow up you, If anything adverse he/she will treat and find the alternatives. Lakhs of people living with HIV are on ART and lead a comfortable and a good quality of life without any problem. So trust your physician and ask her to take ART drugs.
Dr S.Murugan
Most of the ART drugs are well tolerated.
Detailed Answer:
Hi,
Welcome back.
There is no drug, other than water soluble vitamins (Vit. B and C), without any side effect. Your doctor, who prescribing modern medicine drugs for you, will be aware of these facts. He/she will examine you, investigate the blood parameters decides the drugs suits you and closely follow up you, If anything adverse he/she will treat and find the alternatives. Lakhs of people living with HIV are on ART and lead a comfortable and a good quality of life without any problem. So trust your physician and ask her to take ART drugs.
Dr S.Murugan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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