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  • 1.  OI in virally suppressed patients

    Posted 05-12-2021 17:46
    Is OI in virally suppressed patients rare?  What is the guideline for when CD4 drops to two to three hundred, or below 200?  More frequent testing, referral,  medications?

    Samuel Samalin
    Los Angeles CA

  • 2.  RE: OI in virally suppressed patients

    Posted 06-17-2021 13:53
    Hi Samuel,
    Viral load measurement helps to detect initial response to ART and sustained response to ART, with the goal of the patient achieving durable viral suppression. If the patient is already virally suppressed, measuring their CD4 count would help to detect overall immune function.  
    For CD4 count under 200, I would argue to treat with medications and provide more frequent testing to ensure response to therapy. Here are a few conditions that are apparent with CD4 <200
    • Streptococcus pneumoniae Infection
    • Pneumocystis Pneumonia (PCP)
    • bacterial diarrhea/enteric infections
    • Bartonellosis 
    • oropharyngeal or esophageal candidiasis
    • Coccidioidomycosis

    Henry Delu
    Los Angeles CA