dear sir/madam i have started medication for hiv as my cd 4 count was under 200 and vl 40 .000 now im taking darunavir 900mg and norvir 100mg once a day i ve been undetectable for past 4 months but since i started treatment i feel very tired and low all the time? also my sex libido gone out the window.why is that and what can i do about it? many thanks paul

Hi Paul,

I hope you are taking more than boosted Prezista (darunavir plus ritonavir), as the era of monotherapy is long gone.

Fatigue coupled with loss of libido could suggest hypogonadism (low testosterone levels). This is quite common in we virally enhanced dudes. A simple blood test, the free-testosterone level, can diagnose this condition. Treatment is effective and convenient. You apply a testosterone gel topically once per day.

If hypogonadism is not the problem, there are many other potential causes for HIV-related fatigue. Take a read through the archives of this forum. We have an entire chapter devoted to causes of HIV-related fatigue. Because of the associated unhappy state of your Mr. Happy, the two most common underlying causes would be hypogonadism and psychological problems (such as depression). So I'd investigate these possibilities first.

Good luck Paul.

Hope you're "up" (in both senses of the word) again soon.

Dr. Bob