Last month in October, a person living with HIV in the US posted the following to TheBody.Com team which they also sent to me. Dr Benjamin Young responds to such mail. I thought it would be interesting to people living with HIV here in Zambia as this is encouraging:

Hi Ben,

Hope you are well and in the pink of health!

I was an AIDS patient in 2012 with a CD4 of only seven when I was diagnosed. In addition, I suffered from advanced Kaposi Sarcoma (KS) which required me to go for extensive chemo for almost a year, 15 cycles altogether. After which, I told the doctor I wanna stop cause the treatment has created a big hole in my pocket. I am not fully cured from KS because the time when I stopped, there are still small marks on my lungs, and legs.

Ever since I stopped the chemo, my CD4 has jumped from just 56 to 110 and then 156 and 215 and then 236. My last CD4 test was only 219, seems like there is a decline for the first time after two years. I am worried if my CD4 will keep falling from now. I hope it won’t and will still continue to increase because I am feeling good generally healthy and

happy. My KS marks seem to look like small moles now and I am breathing comfortably.

I don’t suffer from much side effects from my current ARV of Truvada and Isentress except for slight heatiness and mild body discomfort once in a month. My only worry now is I tend to sweat over excessively especially when the weather is warm. This is not the usual me before I was diagnosed with HIV. Should i take this as normal ?

What are the chances of me having a normal life expectancy? I am hoping that I will survive through to see the cure someday for HIV.

Presently I am 44 I was diagnosed when I was 42.

I also have a bad habit of keeping late nights like sleeping around 3 am and wake up around 9am. Is this ok for a person like me who is HIV+??

Really appreciate your feedback and advice on this.

Response from Dr. Young

Hello and thanks for posting.

Sounds to me that you’re making an excellent recovery from severe AIDS and KS. Your CD4 count is bound to fluctuate in this pathway, and the small decline that you had on your last test is absolutely nothing to be concerned about.

The sweating that you report isn’t a typical side effect of medications or HIV- it would be worth mentioning this to your care provider. Staying up late isn’t a problem; just make sure that you strive to get an adequate amount of rest.

As for life expectancy, I’d expect good things for you. While you were diagnosed with late-stage disease, as long as you stay adherent to your medications and medical follow up, I’d expect you to live many, many more years, even to a normal life span (which for white male Americans is 77 years).

Hope that helps, and stay in touch.

By another person on November 3, 2014 wrote: Doctor Young , just got my test results today, unfortunately, HIV infection has been confirmed , I was immediately put on treatment as my CD4 is around 55 , i was put on efavirenz 600 mg and emtricitabine200 mg. My question is, are these medicines ok for initial treatment? What side effects can i expect? I feel fine now, but I guess treatment is important at this stage, I am wondering also how long till i can feel safe ( in terms of number. After treatment provided that i eat healthy

and exercise 3 times a week? Thanks in advance for your kind reply

Response from Dr. Young

Hello and thanks for posting.

I’m going to assume that you neglected to include tenofovir in the list of medications that you mentioned. A two drug regimen is not recommended.

Assuming this, the medications you are taking (tenofovir, emtricitabine and efavirenz) are excellent ones, among those recommended by all international agencies.

Usually, this regimen is very well tolerated. The main side effects associated with your medications come from the efavirenz part of the regimen- psychological effects of vivid dreams or wooziness that

typically fade after the first weeks of treatment. Occasionally, mild nausea or diarrhea are also reported.

Your health risks will be much lower once your viral load becomes undetectable, and when your CD4 count rises above 200.

Be sure to work diligently on being adherent to the medications-this doesn’t mean stopwatch level precision, but rather once-nightly dosing and trying to miss as few doses as possible.

I hope that helps and feel free to write back. BY

I am sure these questions and answers will be helpful to many in Zambia. Just a quick response on voluntary male circumcision: studies on this subject have had varied results. In some areas, the male circumcision reduces the chances of contracting HIV and other STIs but in some cases, it does not work out that way and I don’t know why. May be the circumcised do not use any other protection such as condoms because they believe that being circumcised is the answer.

Till next week but if you have any comment or anything you would like to share related to HIV/AIDS, TB, Cancer and malaria feel free to write to

knoxngoma@gmail.com or SMS/call +26095588314

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