Dear Dr. Feinberg,

I have been positive for twenty years (verified by CDC investigation)and I have had AIDS by diagnosis for 11 yrs. I have not had any opportunistic infections. My CD4 counts are usually around 250, my last viral load was <50. I am taking Crixivan, Rescriptor, Combivir, Acyclovir, Paxil, Prilosec, vitamins and anti-oxidants.

I have experienced intermittant, minor night sweats for years. However, over the past year, my sweats have gotten significantly worse. I now soak through at least three "locations" of bed linens a night (I sleep in a king size bed and keep moving to dry locations). The sweating is primarily from my head, neck and shoulders, but does involve my entire body. I have several sets of pillows, which become very wet each night.

I nap frequently during the day without any sweating. It only occurs at night and is worse during the first few hours of sleep.

I have pressed this issue with every physician I know, to no avail. Do you have any suggestions how I might reduce or eliminate this condition. The sweating disruupts my sleep, leaves me frequently exhausted upon waking and has severely affected my quality of life (My partner of 14 yrs and I can no longer sleep together).

Thank you in advance for your advice with this problem.

I'm glad you've done so well for so long. I assume that your doctor has checked for the possibility of an OI or for an "immune reconstitution OI", which sometimes occurs months after starting a a potent combination of HIV drugs that give you immune system a real boost. You don't say whether you've lost weight or ever have any fever, so I'm assuming you haven't. If you do not have an OI or an opportunistic malignancy (like lymphoma), then I suggest you try taking a non-steroidal anti-inflammatory agent at least at bedtime to see if you can control this problem.