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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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magnetic turned poz
Oct 17, 2007

Hi there, I'm a hiv positive 31 yo male, in a relationship with a negative male (24 yo) for 5 years. Last friday, his elisa came back positive, we're awaiting the Western Blot results. My hubby has diabetes typ I, and is under the 'self control' principle: he measures his blood glucose levels 4 to 5 times a day, doses his insulin accordingly, and uses a slow working insulin to counter the gluconeogenesis getting out of control. He's in good shape, although for the last month his blood glucose levels have been hard to control: i'm guessing an hiv infection can deregulate (just like a flu infection can). He showed none of the typical seroconversion symptoms (a good sign on a long term), so his positive elisa came as a shock. In your opinion, given his diabetes I and thus impaired immune system, is his prognosis worse than mine (i "only" have slight bloodpressure problem under control with an ace inhibitor)? Would you agree that starting haart for a year or two in his case, soon after seroconversion, would be a good thing to protect his (gut associated) immunity in the long term? What impact could/would HAART have on his diabetes? (I have no resistance mutations, wild type HIV, assuming he got it from me, he's got no resistance mutations either)

We're meeting my hiv specialist on friday, it would be nice to have your feedback to discuss with him.

Thanks !

Response from Dr. Henry

The actual advantages of starting then stopping ART are unclear and problematic due to disease flare-ups when ART is stopped. Thus, the decision to start ART should be viewed as indefinite-no plans to stop. There are a number of HIV regimens that likely would not aggravate the diabetes much or at all so the decision to start needs to be based on blood test results and general treatment philosophy of patient and doctor. There is no convincing evidence that early treatment preserves the immune system better if treatment is then stopped later. KH

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