another story another love

I want to tell you about a married couple that I have the privilege of caring for. I have known them for about 5 months. They are in their mid-thirties. They are from another country..an Asian country. She is a working professional here and he is a student. They are a delightful couple who exhibit much love for each other.
Several months ago when the wife became pregnant she went to her OBGYN for standard prenatal care. They did her prenatal panel and she tested positive for HIV. This was shocking. Her only love had been her husband, They have been married for many years. She was referred to me by her OBGYN for her HIV care. Her labs indicated that she had probably been positive for quite a few years. Her CD4 cells were kinda low, around 200..(An HIV negative person has CD4 cells from 500 to 1700. below 200 is an AIDS diagnosis and increases your risk for developing some pretty severe opportunistic infections.) It was clear that we needed to test her husband. And of course he too was positive. He also tested positive for Hepatitis C.
It turns out that he had an an anemia diagnosis when he was younger and required mutiple transfusions. Where they come from there is no testing for HIV or hepatitis.

The diagnosis was completley shocking for this couple. He, of course, feels tremendous guilt for infecting his wife. The saddness is very evident. She on the other hand has no anger towards her husband. She understands that he did not know and that it is all an accident. just bad luck, beyond their control.
Now rememer.. her diagnosis came because she was pregnant. we needed to get ther on medications right away to prevent transmission to the baby.
Lets talk about mother to infant transmission. An infant is at risk for becming infected with HIV during delivery. While baby is in mom there is none of mom's blood. The womb is a completely safe place for the neonate. It is during the birthing process that baby comes in contact with mom's blood whether vaginal delivery or c-section. The goal of treatment is to decrease the actual amount of virus that is present in mom's blood to prevent transmission. Every year I have about 3-4 women who have babies and none of the babies have been infected. The rate of infection from an undectable mom is about 1%. Very exciting.

So back to our mom. We got her on meds right away and got her viral amount down to undectable (less thatn 48 particles per ml of blood) We did this rather quicky which was very important beause her baby was actually born at 22 weeks.. He is a miracle and still with us 9 weeks later. and his HIV testing is negative so far.
So this family is dealing with this new HIV infection. Dad just had to start treatment for HIV and in the near furture we will treat his Hepatitis C as well. Both are tolerating their treatment and both have held on to their love. They have chosen not to tell her family whom they share a house with. She is afraid that they will have such anger for him and they did not want to risk that.
In addition, they must have their older son, age 14, tested. I feel confident that he is proabably negative as he has never been sick. But we will not know for sure until he is tested.

I encourage them at evey visit to please get the son tested.

This couple is a true testimony of love. No anger, acceptance of their situation as a family, as a couple. There is a lot to learn from them. Forgiveness, committment and support of one another. I am thankful that they share their experience with me. I am grateful that they have trusted me to assist them in this paart of thier life. I am confident that they will do very well on treatment and live to be grandparents.

This is a fmaily with HIV living a life like the rest of us but with an added appreciation of the life that they havw togetherr. A territfic lesson for me at this time in my life.