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https://fcmaesthetics.com/freeglp1coaching Dr. Gerard Acloque Jr., MD Hollywood, FL This channel (Florida Concierge Medicine & Wellness/Dr. Gerard Acloque), its content, and the opinions expressed by Dr. G are intended for informational purposes only and do not constitute medical advice. The content provided on this channel, including videos, comments, and other materials, is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified and trusted health provider with any questions you may have regarding any medical condition. Never disregard professional medical advice or delay in seeking it because of something you have seen or read on this channel. Reliance on any information provided by this channel is solely at your own risk.
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Let me answer this in two levels. HIV is one of the infections we need to consider but if someone is having weight loss, that individual needs to be evaluated thoroughly because other infections has to be kept in mind. Weight loss can happen because of other disease, it can happen because thyroid disease, tuberculosis, could be because of cancers could be anything. So meet a physician who has expertise in managing this, as regards oral thrush and oral hairy leucoplakia is if a person is repeatedly HIV negative, some of the common causes for oral thrush besides the immune system becoming weak or the immunodeficiency because of the HIV are of they are on medications such as steroid inhalers or on other medications which change the bacteria in mouth which can result in thrush. One also has to consider sometimes the fact that these conditions may be misdiagnosed, sometimes just a normal coating of the tongue can be misdiagnosed as oral hairy leucoplakia and oral thrush and these things needs to be kept in mind and an experienced physician with expertise in this such as an experienced HIV doctor will be able to differentiate or make put the difference between true oral thrush and true oral hairy leucoplakia and something benign like coating. What actually happens is the mind and the body is not separate. In our practice we see everyday in people coming from various parts of the country and the world where someone has had the exposure and following the exposure there is a whole range of emotions such as fear, such as anxiety, shame, stigma. It is hard to discuss these things. Because the test comes as negative repeatedly, but these emotions are so traumatising, they look on the internet and find all kinds of information and some of them are not reliable and they are unable to process and accept the fact that they are actually negative and move on. In order to help in this situation, one needs to meet with an integrated team where there is a psychologist and an HIV expert or HIV doctor working closely together to create a programme for someone suffering from this and if done right and if there is good engagement by the patient, who is going through these symptoms, people feel excellent outcomes and people do feel much better. So I urge you to discuss these thigs with an HIV team where a psychologist and an HIV expert are working together.
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The question asked here is there is this lady who has been diagnose with HIV 8 years back and has been on medication but all of aa sudden for the last 6 months she has lost weight, feels very tired, and has fever on and off. She wants to know what is happening with her. So I can imagine how you must be feeling because you have been on medication for last 8 years, which means you would have expected that you should have been more healthier and mow suddenly you find that you are losing weight and you have fever on and off you feel very tired. These things can happen when the medicines stop working on the person. It does not happen all the time It does not happen all of a suddenly. It could be that you would have missed your HIV pills sometime or may be more often which results in the drugs or the medicines not acting so well in the viruses so well, which is called as a HIV drug resistance or a failure, failure of the drugs to act. It is like when you take antibiotics for a long time and suddenly you find that the doctor changes you antibiotics because these antibiotics have stopped working on a particular infections. So similarly, these medicines also might have stopped working for which you need to undergo certain tests to know if there is a failure. The first would be a viral load to assess if the virus level is going up because if you have been om medicines for last 8 years, which means the viruses would be undetectable, which means even though the viruses would be there, it will not be visible even though the test is done. So it is on that very low level and the second test would be genotyping. Supposing the viruses are not present, but we find certain number of viruses, then you have to undergo something called as the genotyping, which will tell you as to what type of resistance you have developed, that means which type of drugs have stopped working on you out of the drugs you are taking and which drugs will act better and we will change the medication according to the result. So I suggest that you see an HIV specialist and visit a place where there is a team of doctors who is bets in HIV and there is a person who does the test called as viral load and genotyping because this genotyping is done only in very few labs, 4 or 5 laboratories all over India. So it is best to seek help and get it diagnosed early.
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