Hello Doctor Bob, I haven't written to you in quite sometime. I'm Writing about my dear friend again. He is experiencing some real problems with fatique he has absolutely no Tcell count he has done many of the trial programs. He doesn't look Sick or for the most part act sick but now he is experiencing Warts in his mouth on his legs ,groin ,but they are showing outside his mouth on his lips he is very self conscious and the doctor told him they can cause cancer. Any treatment ideas or causes for this? He is going through many highs and lows and we are just trying to keep his spirits up major depression going on.Thanks again for being the guardian angel and the ray of light in a scary and dark world. Audra

Hi Audra,

Warts are caused by viruses and can be difficult to eradicate when the immune system is deficient. However, an HIV-knowledgeable dermatologist can usually keep the problem in check with periodic treatments. Ask your HIV specialist for a referral.

Fatigue, in the setting of HIV disease, is often multifactorial. Consequently, your friend needs a thorough evaluation to determine all of the potential causes. Certainly his "major depression" could be part of the problem. Counseling, support groups or antidepressant medications may well help. He should also be evaluated for anemia, hormonal problems (low testosterone, low thyroid hormone levels, adrenal insufficiency), an unrecognized opportunistic infection, inadequate sleep/diet/exercise and medication toxicities/side effects.

Thank you for helping your friend through these difficult times. I wish all those struggling with the challenges of the "scary and dark world" of AIDS had a compassionate friend like you to help them.

Please give your friend a hug from me and save one for yourself as well.

Dr. Bob