Wife diagnosed as HIV+

[dontoearth]

For you both, I will hope for the best for you. For you, I use prep and have had no problem. This reduces my chances of infection from a partner. They monitor the blood once after you start to make sure there is no liver toxicity. They do it every 6 months or a year after that. I would definitely say it gives peace of mind even tho.' I am not that active these days. For you wife, The newer HIV drugs which utilize lower dose combo therapies have eliminated a lot of the side effects like wasting disease and body fat redistribution and facial deformities from the early years of medications. I am not sure of the present protocol but you might look at the website for the Center for Disease Control in the USA on whether recently infected persons should start medication or monitor symptoms and wait. That would be the most up to date. For everyone, And by healthy lifestyle, NO BOOZE or drugs, no late nights, more fresh foods including vegetables and fruits and nuts and seeds. Less meat and dairy. No junk and crap from 7-11 like chips, crackers, snacks fried in oil. No western fast food with all the empty non-nutritional calories that McD's, KFC, Dunkin Donut are pushing on the world. And definitely 30 minutes or more of walking or light exercise everyday. I have seen all sorts of people improve their health from very bad diseases by eating all the wonderful abundant fresh fruit here in Thailand and supplementing that with carefully selected meals with grain and vegetables. More walking can be accomplished by just avoiding the soi lane motorcycle taxi. Good Luck 2 u.

[patrick1968]

best of luck mate stay strong ....

[Sheryl]

DELETED

Nowerdays HIV tests are nearly 100 % diagnostic. If you are HIV positive that does not mean that you have any symptoms. Many people are HIV poistive for 5 to 10 years without any symptoms. That is one of the problems with HIV because these people are sick and can infect others but they don't know about it.

Whereas HIV antibody test are being used for Diagnosis, they should not be. They are a Screening test. They are being used as Diagnosis as there is no "Gold Standard" to diagnose HIIV. Thhat is no independent method to check and to diagnose HIV infection.

Moreover the Positive predictive value ( probability of being HIV+ when you test + ) ( PPV ) When the HIV prevalence rate is 0.1% (That is one person in 1000 are said to have the HIV virus. ) Which is standard through most of the world then the PPV is 20%

Which means that the test will be wrong 80% 0f the time

In the case of Thailand the the HIV prevalence rate is said to be 1%. In which case the PPV is 72% or wrong 30% of the time

How the prevalence rate is obtained is somewhat dubious but that is another topic

http://uhavax.hartford.edu/bugl/treat.htm

As to transmissiblity the Padian Study of 175 HIV-discordant couples [one partner tests positive, one negative] showed Zero transmission over a 10 year period

http://reducetheburden.org/the-padian-study-sex-is-not-the-problem/

http://aje.oxfordjournals.org/content/146/4/350.full.pdf

Also a more recent Australian-based study of gay male couples of opposite HIV status came up with the same result: - that is Zero transmission

http://www.aidsmap.com/No-HIV-transmissions-from-HIV-positive-partner-seen-in-Australian-gay-couples-study/page/2949294/

The viral load test will confirm that she is definitely HIV+ one way or another for 100% certainty, or not?

Yes, absolutely

In addition the antibody based tests (which are indeed a screening tool only) are done in stages - one type initially and then a confirmatory test if the first is positive. The risk of a false positive on both tests is low.

These are then followed by a Viral Load test, which is definitive.

Incidentally all the prior post content above about Positive Predictive Value assumes that the people being tested, as a group, have the same overall prevalence of HIV as the general population, which is usually not the case. No-one recommends indiscriminate mass screening for HIV, and people getting HIV tests are usually getting them because of a definite risk factor.

[Maestro]

Removed an off-topic post and the replies to it.

[Autonuaq]

It is very sad to hear when people got things like you are confronted with.

there are a few things I want to add.

It is the doctor, nurse that make you recover not the name or the hospital. with this I refer to the person make you recover regardless where he or she works.

HIV it self is going to be seen more and more as a kind of illness that on can live with and as it is looking now one can even become very very old and die on natural causes not related to HIV/AIDS

Also possible to have a good quality of life.

never listen to the judgment of one doctor or a few. There is always development.

I tell you this in another case with a small child that had neuroblastoma. a kind of cancer that is easy to detect and when removed the core cell and all is solved.

I went to many doctor that there was something wrong.

my daughter of 1,3 years had a light difference in her chest. and some other things that I could not place.

did visit and see many doctor and well know hospitals.

all experienced very well know and so on and so on.

all they told me I was too worried as young father and there was nothing wrong.

So time went by and after a few months! My mother went with her to the doctor, the docter was a GP who just came form the university and was doing it practical your at the office otf the GP on my Mother. The man look at my daughter for 3 minutes and ordered herto the hospital,3 hrs later she was at ICU and 6 hrs later she was operated and the Neubalsome was removed 6x9x4.5 cm in the chest of a baby. many thing come aqt the same time.

one find out the the more one know the more one know that we not know.

With this I just want to tell you NOT let you get impressed by titles or names.They were all wrong.

And my daughter she is now 20 of course we have concerns since this is a cancer not fully understand, She is one of the subject that you find back in the medical literature of this cancer type.

She Lives because We where not impressed by names or not impressed by the answers provided.

for you and all the others. I know it is difficult and fair one, still in the unknown get used to it and still can have a good long time with a good quality of life.

Wish you all a very good happy and long time

[dirtycash]

fair play to you for seeking advice on here.

[kiwikeith]

I have no experience about the system here but I do know a long time friend living with the same diagnosis. The key is to live as healthily as she possibly can. If she smokes, stop. If she drinks, stop. change the diet to as much fresh fruit and vegetables as possible. Maintain a healthy weight and outlook.

The immune system is attacked by poor diet and stress and anything she can do to alleviate those 2 conditions will help her survive the disease and the effects of any drugs which are very powerful and not without side effects.

So I would also engage a nutritionist if you can, either via insurance or privately because it is that important. My friend has been healthy and has shown no signs of AIDS related illness for 4 years since diagnosis.

I pray that your wife has similar results.

I don't know where you live but aids medication is supposed to be free to thais under a med scheme, cant remember name.

Just go to a good local hostpital Bummmingrad are theives.

A thai family menber got it and I helped him with this, hes ok now but still smokes which kicks them around.

The key is in the above post , live a real health diet.

There is possibility that aids can surface after ten years with no symtoms , sorry to hear of your plight.

[wprime]

If you are testing HIV- you need to go on anti-virals asap. You could be infected (it takes up to 3 months to show up on a blood test) but still at low enough concentration that you can be treated.

[Sheryl]

If you are testing HIV- you need to go on anti-virals asap. You could be infected (it takes up to 3 months to show up on a blood test) but still at low enough concentration that you can be treated.

Please disregard the above advise. No doctor would recommend this. Having not become infected earlier the odds are against your having been infected too recently to have antibodies, and even if you have been there is little advantage to starting treatment now as opposed to a few months later. The risk of taking what are most likely unnececessary meds well outweighs any benefit. (If you were female married to an HIV+ man the odds would be a different)

BTW a negative antibody test is >90% accurate (though not 99%) at just one month post infection. So while you do indeed need to get repeat tests in 3 and 6 months to be certain, it is very unlikely you are infected.

[jimmiejackson]

Thanks again to all the posters (both publically and through PM) who have helped so far. We all know strangers on the internet can be unusually cruel and critical but I have found the opposite to be the case in this instance and am very grateful for it.

So today we received the first full blood test results. As promised I will keep posting updates, in the hope of both some input from others as well as to help someone in the future make sense of things quicker if they find themselves in my situation.

I will give approximate readings, so as to retain some semblance of anonymity.

The key points I guess are:

The HIV test came back as "positive".

Anti-HBs says result "positive" and reference "negative", and HBs AG (Rapid) result was negative (0.3 with reference range <1) still not clear what this really means after Googling it but it appears this means she is immune to Hep B and this is something we can forget about? I do hope so...

HIV Viral Load is approx 7500 Copies/ml

Absolute CD4 is approx 370 cells/cu.mm

%CD4 is 24 (reference 26-40)

So that's where we are right now. Waiting for her to go to her SSF hospital asap to see what they recommend and will prescribe and then will take it from there.

[Sheryl]

She does not currently have Hepatitis B. She either had it in the past or was immunized, in either event rendering her now immune. Unless it is certain that she was immunized for Hep B, you yourself should also get checked as her prior infection could have been active during time she was with you.

She needs to start ART, obviously. Her immune function is already showing a decline from the virus, though not yet at the point where she would show clinical signs of AIDs.

She is currently infectious, so be careful about always using condoms.

[jimmiejackson]

She does not currently have Hepatitis B. She either had it in the past or was immunized, in either event rendering her now immune. Unless it is certain that she was immunized for Hep B, you yourself should also get checked as her prior infection could have been active during time she was with you.

She needs to start ART, obviously. Her immune function is already showing a decline from the virus, though not yet at the point where she would show clinical signs of AIDs.

She is currently infectious, so be careful about always using condoms.

Thanks Sheryl. That helps a lot. I'll get it checked out either way, although she thinks she was immunized (I think I may have been too but no harm in checking).

Should have more info after the hospital visit but from what I've read, she certainly needs to start ART asap. Seems as though we were lucky to have caught it at a point where, while not great numbers-wise, are still in decent enough shape for there to be a positive outlook with the right treatment.

[Fairynuff]

Jimmie you should be really proud of yourself. You may not think it but you're an amazing guy, supportive, loving and level headed where many guys might just cut and run. Sheryl, you're pretty amazing too, totally non judgmental and an absolute asset to the forum where topics like this often attract extreme negativity. Well done to both of you. Jimmie please keep us updated and good luck to both you and your wife. I'm sure she's proud of you too.

[dddave]

I have a friend who met his wife in 2000, married her in 2002. She discovered she was HIV+ in 2003. I had drinks with them a few nights ago. She looked healthy and normal. She enthusiastically told us about the mushroom farm she began back in their Khon Kaen home last year...already financially successful.

I won't say she hasn't had some hard times: she has. Several times she either got run down or was depressed and didn't stick with her medical routine. Twice, she was close to death. She was fortunate that people around her cared, took action and helped her make it through those episodes.

I've written on this forum about my GF's brother before. He was diagnosed HIV+ more than 12 years ago, nearly dying at the time. He has held a full time job and has supported himself and his family for nearly the last ten years.

In both cases, they were treated by the free government HIV program in Khon Kaen, getting monthly check-ups and free meds. I can't prove it but I suspect that patients in this system are better off than those using private, profit making hospitals. It just seems more patient focussed to me.

[KC 71]

Sorry to hear that jimmiejackson

[beano2274]

dont wait too long to get the meds, like I said if you do not mind paying go to the clinic under Big C Saphan Kwai down the stairs at the main entrance is on the right hand side, this doctor will prescribe them straight away, if you tell him you do not want to wait too long.

If I remember correctly my results were:

HIV Viral Load was approx 180000 Copies/ml

Absolute CD4 was approx 585 cells/cu.mm (reference 538-922)

%CD4 was 19 (reference 26-40)

[jimmiejackson]

Thanks again for the advice and support since my last post.

After some run around and a bit of bad experience with one of the Doctors (attitude wise), my wife eventually found herself talking to a "Psychologist" (I'm really not sure that's the correct term but my wife insists that's what she introduced herself as) at her assigned SSF hospital who said she works directly for the SSF and is assigned to the hospital to take care of the cases of HIV+ patients.

She was apparently very caring and friendly and prescribed my wife the following and gave her 30 days worth:

Efavirenz 600mg, Tenofovir GPO (Viread) 300mg, Lumivudine 300mg (2x150mg) to be taken at 10pm daily.

All of which were free. She told my wife to come back in a month for a review and to get more medication and that they will do another viral load/CD4 test in 6 months to see how she's responding.

All of this was free and my wife seems comfortable with the "Psychologist" so that's a good thing I guess.

We have an appointment to meet Dr Asda next week. I want to take her blood tests and the medication along and get a second opinion from someone I can talk to directly in English.

A couple of people have said that tests like an EEG (to measure heart performance) are important before starting certain medications, and that blood tests every 1-2 months in the first 6 months are recommended. I'm ok paying out of pocket for blood tests at the Red Cross if my wife can't convince her SSF Hospital to do it, if that's what has to be done. Although I'm sure I could stretch to afford EEGs/Blood Tests at Bumrungrad I'm in a position where I really have to balance cost/effectiveness and if I can get those things free/cheaper elsewhere that is vastly preferable.

Any feedback on the medication? Any advice before going into meet Dr Asda?

Again, I really appreciate anyone taking the time to give me some tips or feedback.

[Sheryl]

EEG is a neurological test and not in any way needed. You may be thinking of EKG, but in an otherwise healthy pre-menopausal woman that too is not indicated.

What is important is tests of liver function (ALT, AST, bilirubin), kidney function (creatnine), complete blood count, lipid profile (cholesterol, triglycerides) and screening for diabetes (fasting glucose or Hb1ac). These are all blood tests, would have been a single blood draw and I would be very surprised if not already done.

They should then be repeated at least once a year, more frequently if abnormal.

There should be no need to pay out of pocket for any of these tests, they are easily done at any hospital and part of standard ART treatment prototcol.

Get copies of all her test results before you go to see Dr. Asda so that none have to be repeated. Lab work at Bumrungrad is many times the cost of elsewhere and in no way better.

[beano2274]

EEG is a neurological test. You may be thinking of RKG bit in an otherwise young and healthy person that too is not indicated.

What is important is tests of liver function (ALT, AST, bilirubin), kidney function (creatnine), complete blood count, lipid profile (cholesterol, triglycerides) and screening for diabetes (fasting glucose or Hb1ac). These are all blood tests, would have been a single blood draw and I would be very surprised if not already done.

They should then be repeated at least once a year, more frequently if abnormal.

There should be no need to pay out of pocket for any of these tests, they are easily done at any hospital and part of standard ART treatment prototcol.

Get copies of all her test results before you go to see Dr. Asda so that none have to be repeated. Lab work at Bumrungrad is many times the cost of elsewhere and in no way better.

The whole blood picture should be looked at like Sheryl above says, I have mine done every time, we look into all the functions.

jimmiejackson I had an issue with the tablets that your wife has been prescribed, they actually affected me and my cretinine levels were bad, I changed to the meds I previously described and have had not issues since

[Sheryl]

A post with very dangerous and completely inaccurate misinformation has been removed along with replies to it.

[watcharacters]

I can only add I wish both of you the best of luck.

[Sheryl]

One thing worth discussing with Dr. Asda would be whether the hospital your wife is registered at is the best of those which accept SS. First get the list of hospitals in your area which accept SS patients, from the SS Office. Your wife can change hospitals if she wants, though the change can only be made at certain times of the year.

The hospital she is at may be fine (it is a positive sign that they apparently have a case worker coordinating HIV care), but good to check.

[beano2274]

Sheryl I think the most important thing is to start treatment then will some careful planning and investigation look into other hospitals that might be closer, but if his wife feels comfortable the the current Doctor then it is best to stay where they are, I noticed a different attitude towards me in some places, and was left feeling uncomfortable, but I must say that the Red Cross were the best place I visited, maybe it was because of the Big receptionist "Fai" who smiled and made everyone feel comfortable.

[Sheryl]

Yes, of course she should start treatment, that is a given, and as I understand it she already has. A change of hospital would be only if there is a clear benefit to such a change, and would likely take some months to effect.

As this is a life long disease it is worth going to the trouble of ensuring she is registered at the best hospital under SS that is available to her.

[jimmiejackson]

I have noted a list of questions to ask and have made a copy of her blood results to bring with us, so I'm coming armed.

Again, thanks for all your help. It's made this situation far easier to deal with as I've been able to get so many answers here along the road so far. This is more valuable than I can express, so thanks for taking the time.

[sanukma]

Was just made aware of this thread by a friend. Who has indeed been in contact with the op on pm's so that is good.

For myself I was diagnosed about 3 years ago when I was living in Thailand. It caused me to resign my job and move back to farangland. Something I know now was a bit of over reacting, but seemed like the right thing to do at the moment.

Just wan't to say to jimmiejackson that you and your wife can take it easy now. It will most probably be smooth sailing towards undetectable viral load and cd4 numbers well within the normal. The side effects of the medicines are not anywhere near what you can read about on sites on line. It is just fear mongering and you should ignore it. From what I know the medicines you get at government hospitals in Thailand works very good. I would guess that with a viral load around 7K as you stated earlier she had she will be undetectable within a month or less.

For myself I went from 110K to undetectable in 20 days. Hopefully has been put on a regime that she only has to take once a day. Even if it's several pills to take it makes it much easier to just have one time to worry about.

I'm on a one pill regime called Stribild, but this is not yet available in Thailand. Probably should be in not too long time. But will be very expensive until a generic comes on the market. But if this becomes available and affordable your wife should consider to change to it. The advantage of this medicine is that it's not so time restricted on when you have to take it. I actually have a window of 6 to 8 hours +/- what ever time I took it the day before.

Would also give a thanks to Sheryl the moderator. It looks like she has managed to keep the bull shit that thaivisa forum is so famous for off this thread.

Don't believe any of the conspiracy theories or alternative medicine mumbo jumbo. HIV is very very real and the only thing you can do to avoid AIDS and eventually an untimely death is to get on the program and take the meds.

Good luck to you and your wife.

Cheers

[jimmiejackson]

Was just made aware of this thread by a friend. Who has indeed been in contact with the op on pm's so that is good.

For myself I was diagnosed about 3 years ago when I was living in Thailand. It caused me to resign my job and move back to farangland. Something I know now was a bit of over reacting, but seemed like the right thing to do at the moment.

Just wan't to say to jimmiejackson that you and your wife can take it easy now. It will most probably be smooth sailing towards undetectable viral load and cd4 numbers well within the normal. The side effects of the medicines are not anywhere near what you can read about on sites on line. It is just fear mongering and you should ignore it. From what I know the medicines you get at government hospitals in Thailand works very good. I would guess that with a viral load around 7K as you stated earlier she had she will be undetectable within a month or less.

For myself I went from 110K to undetectable in 20 days. Hopefully has been put on a regime that she only has to take once a day. Even if it's several pills to take it makes it much easier to just have one time to worry about.

I'm on a one pill regime called Stribild, but this is not yet available in Thailand. Probably should be in not too long time. But will be very expensive until a generic comes on the market. But if this becomes available and affordable your wife should consider to change to it. The advantage of this medicine is that it's not so time restricted on when you have to take it. I actually have a window of 6 to 8 hours +/- what ever time I took it the day before.

Would also give a thanks to Sheryl the moderator. It looks like she has managed to keep the bull shit that thaivisa forum is so famous for off this thread.

Don't believe any of the conspiracy theories or alternative medicine mumbo jumbo. HIV is very very real and the only thing you can do to avoid AIDS and eventually an untimely death is to get on the program and take the meds.

Good luck to you and your wife.

Cheers

Thanks for taking the time to give me some advice and tell your story, and thanks to your friend for letting you know. I'm hopefully that things are on track and hearing stories and comments by people who really know the situation helps so much with keeping us upbeat. I was expecting far less when I started this thread, I feel blessed really.

Many posters have helped a huge amount but Sheryl as moderator has to be thanked specially for helping keep this thread (and therefore me) free of distraction or hurt by unnecessary comments. You're an angel and I thank you for it.

[sanukma]

I would also like to add that if you and your wife was planing to have a child in the future you still can.

With close supervision from the doctors it is possible for your wife to give birth to a perfectly healthy hiv negative child.

In my country there has not been born a hiv positive child since 2002 but plenty healthy children born to positive mothers.

That is as far the medical science has come now. It's truly amazing.

Once this initial shook has gone over you will both be back to normal.

Once again best of luck

[jimmiejackson]

I wanted to post an update.

We went to see Dr Asda at Bumrungrad, as suggested by several people. The purpose of this was to ensure that we had someone who is highly qualified and in touch with developments that I am able to speak with in detail, as well as my wife. Although the care by the Red Cross and my wife's SSF hospital seems to have been very good so far, this isn't something I want to have any worries about language barriers or bureaucracy getting in the way of my total understanding of everything. I have been recommended some wonderful Doctors who would see or speak to my wife for free and I appreciate that. I feel that as I am able to afford the Consultation (which was 1300 Baht) with Dr Asda, I should allow these Charity Doctors the time to treat those that don't have anywhere else to turn.

The Doctor was very personable and knowledgeable. I explained to him that we wanted to keep the treatment as cost-effective as possible while making sure we weren't cutting any corners. He was very understanding, giving us pointers of what we can expect for free and what to pay for but get as cheap as possible.

I had a list of questions that I went through, all of which he was happy to take the time to explain. The upshot is that the medication she's been prescribed, while not the absolute newest or with the least side effects, is still the "standard" in Thailand and "very effective". From what I understand the other options currently available are very similar but may have less psychological side effects, and that there is a new drug coming in quite soon called "Complera"which apparently will be quite reasonably priced (no other details available yet).

He suggested the best course of action was to take the drugs prescribed for a month then get a full panel of tests again (including Viral load, CD4, electrolytes, liver function and some others) to see how she is reacting. He said if the SSF hospital won't do them for free it's best to go to the Red Cross and get them done there relatively cheaply again.

As a result of these tests and a consultation with my wife about how she feels things are going, he said he will have a better idea whether possibly paying for other medicine (or trying to get it from the SSF if available) is worth trying or not.

He spent some time going through the possible side effects and what to look out for. As I have been told my a few people via PM, the side effects are generally not as bad as they sound and tend to go away after the first month completely. I'm hoping that's the case for us.

So that's where we are now.

Again, thanks for all the support so far, I will keep updating this thread with info as it comes in, so that it might be of assistance to others.

[RichardThailand]

I hope everything works out for your wife and you. I recall a while back listening to a doctor who was saying that these days with the new treatments that are available if given the choice between having diabetes and being HIV positive he would choose HIV. I wish you and her continued good healthy for many decades to come.