Question:

Good doctor,
My uncle has been diagnosed HIV positive late last year, he is living by himself. He doesn't know his CD4-count, he has already started being very weak and every now and then he is complaining about fatigue and diarrhea. How can I help him, because I visit him every morning before I go to work and even after work to bring him food (vegetables and fruits); my family is considering taking him to an HIV/Aids hospice? Will taking him to a hospice help?

Answer provided by:

Daniel Lee, M. D.
Assistant Clinical Professor of Medicine
UCSD Medical Center
Owen Clinic

Thank you for your question. I would recommend that you take your uncle to see a doctor that specializes in HIV. An HIV/AIDS hospice may be helpful, but only if there are doctors who know how to take care of HIV. When we talk about having a patient here in the United States going to hospice, we are usually thinking more about end of life care, which means that the focus is on making someone comfortable. This may mean just giving fluids, food, and pain medication as needed, but not to do any more testing or treating of any diseases that the person may have. In South Africa, I do not know what HIV/AIDS hospice care exactly means. It may be different than what I have described above. I presume that your uncle has never taken any anti-HIV medications and thus, he probably should be seen by an HIV specialist who can get him started on anti-HIV medications. The specialist may also be able to determine why he is having diarrhea or why he is tired. My guess is that HIV is causing some of this, but it is possible he may have some other type of infections which may be causing this. If the HIV/AIDS hospice is the only place that has HIV specialists, then I would recommend taking him there, but if it is only a place for those with HIV/AIDS to die, then I probably would not take him there until he has at least seen an HIV specialist and has tried anti-HIV medications. I hope this helps. Good luck.

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