On Living with HIV

I think I've got a thing for this retrovirus a.k.a. human immunodeficiency virus. Not that I wished I have it, touching wood no, but somehow, of the many diseases that I've came across, I somehow feel more connected to patients who were unlucky enough to get infected with this immunosupressive virus. Especially those who got it from sexual transmission.

I was posted in the infectious disease ward last week when we came across a lot of interesting cases, or so I was shaken awake by another Professor that we should always look at things in an interesting manner. Most of the patients assigned to me were admitted due to dengue fever in the risk of dengue haemorrhagic fever and shock.


So one morning, I went to the ward and found out the bed that I was assigned to had a new admission. Chinese lady. I walked over, she looked pretty beat. Her sister sitting next to her bed were half asleep to. The whole ward was very quiet, as if everyone was waiting for me to initiate the conversation.

"Hi. I'm Medie, I'm a final year medical student here, do you mind if I ask you some question regarding your sister's admission?"

I didn't ask her sister straight away, she was going in and out from her sleep, one time she had her eyes open, and the next second she was asleep. Plus, she looked really tired, I didn't want to bother her too much.

"Sure. Ask away."

Turned out that her sister was admitted due to severe lethargy, wasn't associated with any headache or joint pain, no symptoms of infections in the throats and was pretty alert to time, place and people around her. But she definitely had some infections, spiking fever intermittently for the past 2 weeks; they went to a general practitioner, but no medications was given. 2 days prior to her admission into our hospital, she started to have diarrhoea. All watery, from black colour to yellowish. For the past 1 month she lost 12 kgs, and she lost all her appetite to eat. She vomited a few times, but all were of clear fluid.

I ran through a few differentials in my mind, asking more to rule out each diagnosis. Not likely to be malignancy. Not really TB although it's what we would always think of at first. Not some typical infections either.

Upon further asking, her sister finally said she's HIV positive.

I was stunned for a while. Retroviral infections. Why hadn't I thought about it? She most probably has some opportunistic infections of the gut. She finally told me that they went to a general practitioner and her HIV screening came out positive, and she was asked to confirm the results. So they went to a private medical centre or some sort, and Western blot confirmed the diagnosis.

But the thing is, she was divorced for the past 8 years, and concentrated on her fruit stall business since. She doesn't have any children, and had never been going out with anybody since her last marriage.

She stayed with some married couple before she was asked to move in with her sister so that she could be taken care of all the time. But otherwise, she had no other possible risks.

So the curiosity was guided back to her ex-husband. 8 years back they found out he had been having random sex outside with God knows who. So after they found out, the divorce was finally sorted and they had never heard from him ever since.

I asked her sister if the patient knew about her status, and I was so wrong to have think not everyone would be able to accept the fact that they were positive out of a sudden. So there was a tinge of surprise and relief when I was told that the patient knew very well of her status and was very keen in the treatment.

I hope when the results as to which strain she contracted, her immunity would be enough to sustain her for a while before she was subjected to life-long HAART. It is after all, a very nasty therapy with a lot of side effects, tolerable, but not exactly comfortable.

As for her husband, I wished he'd know about his status as soon as possible before he infect more ladies with what he carries.

Did I mention she's in her late 40s?

Here were some past writings about HIV: story 1, story 2, story 3.