Friday, November 2, 2012

Email 91: On Hairy Leukoplakia and ARV's


Hi PoZZie,

I’d been reading your blog since I was diagnosed with HIV early October 2012, but no confirmatory test result yet. 

As of this time, I was advised by my doctor to monitor my health. I developed hairy leukoplakia but my doctor prescribed me to take betadine oral antiseptic but it was not removed.

I researched and based on this symptom, I am already in STAGE 3, and life expectancy is just 1-3 years if not treated. 

Just in case I am positive and based on the guidelines of WHO and DOH, is it possible to take ARV as an outpatient even in its trial period? So that it will not affect my work? I am totally worried about the stigma and discrimination among my colleagues and this might TERMINATE by my employer if known.

Please advise me what to do.

I am hoping for your response. Thank you!

Gudymonlite


POZZIEPINOY'S REPLY

 Hi Gudymonlite.

 Thank you for your email. Thank you for reading my blog.

 I am glad that you got your HIV test done and just waiting for your confirmatory result. Follow what your doctor told you to do. While waiting, stay healthy and have a healthy lifestyle. Also, you can empower yourself by reading everything about HIV. My blog is a collection of information so I know you can learn a lot from my blog entries.

 Now, let us discuss your concern. Let's discuss what Hairy Leukoplakia is.

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What is Hairy Leukoplakia?

 According to Wikipedia, hairy leukoplakia (also known as "oral hairy leukoplakia") is a white patch on the side of the tongue with a corrugated or hairy appearance. This type of leukoplakia cannot be scraped off, much like other forms of leukoplakia.

 Hairy leukoplakia is seen in severe defects of immunity, particularly in HIV infection. The cause of this condition is an opportunistic infection by the Epstein-Barr virus (EBV). After the primary EBV infection has been overcome, the virus stays latent in the B cells and also causes lytic infection in the oropharynx, controlled by the immune system. Uncontrolled lytic infection in the oropharynx is manifested as oral hairy leukoplakia in immunosuppressed hosts.

 Signs and Symptoms of Hairy Leukoplakia
When associated with HIV or AIDS, hairy leukoplakia may be one of the first signs of infection with HIV. It was originally thought that this condition only ever occurred in people with HIV but there have since been cases in other people with suppressed immune systems such as organ transplant recipients and chemotherapy patients. It is often the first sign that the immune system is weakening and that the person may be at increased risk of a more serious infection waiting to manifest.
Symptoms and signs of hairy leukoplakia include:
  • Irregular non-painful white patches on the sides of the tongue and less frequently elsewhere on the tongue or in the mouth
  • Patches look corrugated or folded in appearance with tiny fuzzy hair-like protrusions running along the folds
  • Patches look similar to Candida infection (oral thrush), except hairy leukoplakia lesions cannot be moved or dislodge

Treatment of hairy leukoplakia

Hairy leukoplakia is not usually treated specifically for itself. However, gentian violet has been reported to be effective, and a few cases appear to have responded to valaciclovir.
Treatment of the underlying cause such as treating HIV or AIDS with anti-retroviral medications usually helps to resolve lesions. If patients are not taking anti-HIV therapy and hairy leukoplakia causes pain, interferes with eating or affects the voice, antiviral medication with aciclovir or ganciclovir may be used to treat the condition. However, lesions may reappear when antiviral treatment is stopped.
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Going back to your email, you were right that you are on Stage III in the clinical staging of HIV/AIDS, well in case you have HIV. But that doesn't mean that you are terminally ill. I was on Stage IV before because I had pneumocystiis pneumonia and bibasal pneumonia, with CD4 of 70. Now I am back to normal living, not getting sick for 13 months now and has been back to work after 3 months of taking my ARV's (9 months ago).
Because I don't know what hairy leukoplakia is, I texted Dr. Ditangco, the head of RITM-ARG. I asked her if you can be treated with ARV's as soon as your confirmatory comes out. She said it depends on what the doctor will tell you. I told her that I would refer you as soon as your confirmatory comes out. She advised me to tell you to go to RITM-ARG in Alabang even without the confirmatory, so you can be treated ASAP. So there. Please email me your contact number so I can have you assisted when you go there. 
About taking ARV's, you don't need to be confined while you are on a trial period. You can take the ARV's at home for 2 weeks. Definitely you can go to work as long as you don't feel any side effects which you are required to tell your doctor. If you are in the Philippines, you can't be terminated from your employment as it is against the law here.
Please email me your contacts so I can assist you in RITM-ARG, in case you are in the Philippines. As what Dr. Ditangco advised you need to go ASAP to RITM-ARG in Alabang so you can get treatment even without the confirmatory.
I hope I was able to answer your questions. Please feel free to email me again if you have other concerns.

Stay healthy,
Pozziepinoy


"WE ARE ALL IN THIS TOGETHER.
NO PLHIV is alone with his or her struggle with HIV!"

-Pozziepinoy-


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