Email 490: Concerned About ID Doctors

Posted by Pozziepinoy on 8:54 PM

Dear Pozziepinoy. 

Bakit ang mga infectious disease doctors dito ay hindi nire recognize na during initial infection ay pwedeng magkaron ng reactivation ng latent virus like cmv dahil during initial onset of hiv ay nagkakaroon ng severe immune and cd4 depletion. Sa US ay kasama sa diagnosis yun. Di ba nila alam dito na ang cmv ay immunosuppressive kaya  
the more na at risk ang patient to advance the hiv disease faster? Ang alam lang yata nila ay ang cmv acquired pag severe o late na stage. At dahil di pa skin and bones ang patient at initial presentation kahit nagco complain na sya ng eye floaters with slow vision lossband colitis na symptoms of cmv ay sinasabihan pa nila na psychological lang. Paano nila matutulungan ang isang patient pag ganun kung sila mismo ay sarado ang isip.


POZZIEPINOY’S RESPONSE

Hi there.

Thank you for your email. Thank you for sharing your concern with us.

Since I am not a doctor, I asked Dr. Ditangco, the Head of RITM-ARG to answer your email.
She approved that this response be posted here:

"This is a very technical question. A simple answer is this: although it is true that during acute hiv there is immune and cd4 depletion, the risk of developing cmv reactivation presenting as retinitis or colitis is unlikely because the cd4 does not usually drop to the level (below 100 cells/mm) that will put someone at risk of deloping such cmv disease during initial or acute hiv infection. 

If the patient really feels something is wrong with his vision or suspects colitis he could go see an eye or GI specialist for check up. The symptoms might be due to other causes and not cmv."

I hope the response of Dr. Ditangco answers your concern. Feel free to email me again if you have other questions.


Stay healthy,
Pozziepinoy






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