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Bipolar and just tested HIV positive
May 25, 2005

Hi. My mother tested HIV positive a week ago with CD4 count at 180 and viral load at 57, 400. Since then, the man who claimed to have spread the disease to her has died of AIDS in the hospital after having stayed there for some time. He tried to tell her he was positive some time a long time ago (maybe 5 or 6 years ago), but she forgot about it (she was not paying attention as she was not on bipolar meds at that time) and he had to remind her when she saw him in the hospital. I know that my mother should be on meds right now, but considering she has to take lithium and seroquel for bipolar disorder, with which drug combination would you recommend she start treatment for HIV?

What is the likelihood that any of these medications will inflict her with sleep disorders or depression, even while she is taking her regular seroquel dose? What types of treatments are they? Are they pills or IVs or shots? How often will she have to take each of them?

If she were to develop an AIDS defining opportunistic infection, is it possible that they can bare any influence on how well she is able to sleep or her mood? Please let me know. I am worried about her. I have seen her in her most depressed moods and it is very difficult to get her to listen and wake up to reality and I would like to know what I am going to have to deal with to help her. Will we just have to wait and see? Doctors have already said that she is of the .01% not included among the 99.9%

Any help you can provide will be greatly appreciated. Thank you!

Response from Dr. Henry

A significant minority of HIV infected persons also suffer from mental health disorders so most HIV specialist are familiar with the treatment of patients in that setting. Which HIV drugs are best for your mom depends on many individual factors that are best assessed by an HIV specialist. The majority of persons with serious mental health disorders with HIV can be treated for both with success but it is challenging. Supportive family and friends can be very helpful for patients to deal with the stress involved with juggling so many issues as you describe for you mom. The best way to prevent AIDS-related opportunistic infections is to receive effective HIV treatment and proper preventative drugs (such as sulfa drugs to prevent AIDS-related pneumonia). KH



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