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Procrit drug interactions and re-infection
Aug 1, 2002

Hey Stud, How does a gay guy get a straight answer these days? Here's the questions: 1) My doc doesn't want to give me Procrit because he says it might have drug interactions with my antiretrovirals? Is he right? What drugs do I have to worry about interactions with? I'm so wiped out I'm tird fighting with this dude. He always has an excuse for not running a test or prescribing a medication. 2) A local "AIDS expert" here is telling our support group that re-infection between two HIV positive dudes is impossible. The not so subtle message is that barebacking between to poz dudes is fine. When you were here last year you said that re-infection was indeed a possibility and that we should continue wearing rubbers even if we both are already positive. So what's the latest scoop? Can we take the rubbers off and go skin to skin again? I'm getting excited just thinking about that! Dr. Bob you're the one we trust. Thanks man for being there for us all. Can I take you out to dinner next time you come to town? Confused Positoid Fan

Response from Dr. Frascino

Dear Confused Positoid Fan,

I don't know if I can give you a "straight answer." Will a gay one do? Procrit is a remarkable product. It is perhaps the safest drug we use to treat HIV-related complications. No, it does not interact with any antiretroviral drugs or any other kinds of drugs either!! Sounds like your doctor is either not very well informed or that he is trying to "cost contain" your health care. Either way, it may be time to say, "Happy trails" to that dude and find an HIV specialist who is more competent and compassionate. Your HIV specialist is supposed to be your advocate, not your adversary. HIV is the only enemy we should be fighting with. Push him on the Procrit issue. Starting dose is 40,000 units once per week. It's self-injected. It should help your anemia, thereby improving improve your quality of life and energy level. Also, start searching for that new HIV specialist.

And just who qualified this other guy to be an "AIDS Expert?" The Sally Struthers Study at Home Vocational Course for High School Dropouts? Not only have I not changed my opinion, the news form the Barcelona AIDS Conference strongly supports my view. Dr. Bruce Walker form Harvard presented the most sobering news on this topic. He has been following a group if 14 patients with primary HIV infection. His work has shown that early intervention can help preserve important subsets of CD4 cells, and through a series of treatment interruptions, the immune system might be trained to control the virus. One of the members of his cohort was doing very well controlling his virus until suddenly his viral load took off like a skyrocket! The patient did report an incident of unsafe sex. The new viral strain surging through the patient was identical to that of his new sex partner. This patient confirms that superinfection with a more aggressive strain in someone who is already HIV-positive is indeed a reality. A similar scenario was reported with a patient in Geneva, Switzerland. Two additional examples of documented superinfection were published in the August issue of the Journal of Virology. The evidence is now becoming overwhelming that superinfection is a reality. Exactly how often it occurs we do not know, but that it exists can no longer be denied. You might want to pass a copy of this reply on to that "AIDS Expert" you mentioned. The allure of no-condom sex is strong enough without his spreading misinformation. It could lead to disastrous consequences.

OK, this is about as straight as my answers get.

As for that dinner date, pick me up at 8 p.m., OK?

Stay well.


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