Question:

My daughter is 21 and was diagnoed with HIV/HepC at the end of 2002. She is a drug addict, and has been battling her addiction for 6-7 years. Her levels started out at 596 and a low viral load count. She has been in and out of re-habs and jail. She contracted HepA while in prison last year. She came out of a recovery house in Nov. of 2003 and stayed clean for the remainder of the year. Since then she's been using crack cocaine daily. She looks like a skeleton with skin. She feels lousy all the time. She just had her levels done a couple weeks ago. She called for the results yesterday, and they were 302 and, 44,000. They want to start her on meds. They told her that the meds would not work until she stops smoking the crack cocaine. Is this true, and what are her chances of catching this virus before in turns into full blown AIDS ? I'm scared to death that she may just give up. She has a 2 1/2 year old daughter that my husband and I have been raising. I want to help her, but I can't force her to do anything.

Answer provided by:

Douglas T. Dieterich, M. D.
Chief of Gastroenterology and Hepatology
Cabrini Medical Center
Assoc. Prof. of Medicine NYU School of Medicine

This tragic story sounds less like a medical one and more like an addiction issue. You need to get some help from Al -Anon or a narcotics equivalent to help deal with this. The CD4 and viral load are not in bad shape, and by the use of meds, when appropriate, the CD4 can rise and the viral load can fall. The HCV can be treated as well, but not until the cocaine is dealt with. She is lucky to have survived the hepatitis A, the mortality with HIV and HCV is about 40%! Try to get her into treatment and take very good care of the precious child, and get some help and insight for yourself to better cope and care for the child!
Good luck!

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