Hi Pozzie,
I stumbled on your blog months ago but I just gathered the courage to email you regarding my concerns. I have been diagnosed with HIV in 2010 when I was still in Singapore and went to Thailand after a month to get a second opinion (I was still in denial). Prior to this, in August 2009 I had this skin disease called Herpes Zoster which according to the doctor was caused by my weak immune system. Well to cut short, I took some medication and it went away but I never thought about an HIV carrier until I applied for my working pass in Singapore.
In February of 2011 I went to Bumrungrad International Hospital in Bangkok and had a consultation with Dr. Mattana Hanvanich. Here are the test results CD4 Cell Count 385 cell/cu.mm, TPHA "Non Reactive", Viral Load (HIV RNA) 18,400 copies/ml by COBAS. I just want to ask an advice regarding this. I live abroad currently in Italy and I don't know (more of being scared really) to get medical care here as I'm worried that it might affect my residency status here. I have not had any other illness except for the zoster and the almost in the anal area warts which I have removed thru surgical procedure in Thailand in October 2011. You opinion specially on the results mentioned above will really be helpful so I would know how to live my life whilst I'm here. Thank you so much! More power!
Cheers!
XXX
CONTRIBUTOR’S RESPONSE
Hi XXX,
Thank you for your email and reading this blog,
I am glad you have found the courage to email Pozzie Pinoy with your concerns. I can understand your initial reaction. Many HIV+ people first react by going into denial. However, you have now accepted that you are HIV+ and you need to proceed accordingly.
I am also a patient of Dr. Mattana Hanvanich at Bumrungrad International Hospital in Bangkok. She is one of the leading HIV Medical Specialist in Thailand. The advice she gave to you at the time is the advice that you should have followed. Given that it appears that you haven't, you should seek the advice of an HIV Medical Specialist and undergo further tests as required as soon as possible.
As far as the 2 illnesses you have reported are concerned. They both occur/present more frequently when the immune system is compromised.
Anal warts: There is no known cure for anal warts. They are caused by the HPV virus. All that has happened is that you have removed their physical presentation. You still have the HPV virus. If your immune system is functioning within normal ranges, then the likelihood of further outbreaks is reduced. However, the more challenged the immune system, the higher the likelihood of anal warts recurring.
Shingles: The same can essentially said about Herpes Zoster. There is no known cure for it. It is caused by the Varicella-Zoster Virus . It first enters the body causing Chicken Pox, usually as a child. It then lies dormant, usually in the nerve cell body and can reactivate to cause Shingles in adults. This occurs when the immune system is under stress. Like any virus that lies dormant in the body, it can reactivate more than once. The sooner you start ARV the sooner your immune system will recover and the less likely you will be to suffer further outbreaks of either anal warts or Shingles.
The following are the contact details for The National AIDS Centre in Rome, Italy. They can probably best answer any concerns you have regarding testing, your residency status and treatment that is available there.
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National AIDS Center
ISTITUTO SUPERIORE DI SANITA'
Viale Regina Elena 299
00161, Roma, Italy
fax: +39 06 49903002
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Regarding your results, they are a little out of date now and thus can't really be commented on in any relevant sense as retesting now may deliver very different results. The following is some basic information relating to the tests you have already had done though.
CD4 count: A CD4 Cell Count or 385cell/cu.mm is indicative of stage 2 HIV infection. That is, a CD4 count 200-500 cells/uL (cu.mm) provided you have no AIDS defining conditions. The guide lines regarding the commencement of ARV therapy vary from country to country. In countries whose ARV is not provided free by The Global Fund, such as Thailand and Italy, ARV is usually initiated when the CD4 count falls below 500 cells/uL. ARV can be initiated when the CD4 is higher if the patient is willing and the HIV Medical Specialist considers it necessary.
Viral load: The definition of a high viral load is somewhat subjective but generally, anything over 50,000 copies/ml may be considered a high viral load. One of the aims of ARV is to reduce the viral load to undetectable levels. While this depends on the sensitivity of the measuring equipment, this usually occurs when the viral load falls below 40 copies/ml. Generally speaking, the lower the viral load the lower the risk of damage to your immune system and the less infectious you become. Remember though, even if you have an undetectable viral load at any particular moment, you can still infect others.
TPHA test: This is a highly sensitive and specific test for the serologic diagnosis of syphilis. A "Non Reactive" result indicates you did not have syphilis at the time of the blood test. A "Reactive" result would have indicated that you did at that time. It indicates nothing about your status in that regard now.
I hope you have found this answer helpful.
Credits: 1) http://www.hiv1tat-vaccines.info/contact.htm
2) http://www.lexic.us/definition-of/TPHA_test
3) Dr. Mattana Hanvanich, Bumrungrad International Hospital, Bangkok, Thailand.
4) The Thai Red Cross AIDS Research Centre.
5) United states Centre for Disease Control.
Stay healthy, stay compliant with your ARV regimen,
Malcolm Brown
International Contributor
"WE ARE ALL IN THIS TOGETHER.
NO PLHIV is alone with his or her struggle with HIV!"
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