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Ask the Expert Hot Topics
June 16, 2003

Check out these hot topics at The Body's Ask the Expert forums:
Starting HIV Treatment What do you think of starting HIV treatment with tenofovir (Viread), 3TC (lamivudine, Epivir) and efavirenz (Sustiva)? I am two weeks into my first HIV treatment regimen and I have a rash from the efavirenz. My doctor wants to switch me to Kaletra (lopinavir/ritonavir). What do you think? I started treatment right after I was infected even though my CD4 count was high. As you know, there have been proven immunological benefits to this strategy. How long do you think I will have to stay on treatment? Mixed-Status Relationships I'm an HIV-positive man, but my boyfriend is negative and wants to have unsafe sex. What should I do? My partner cheated and was infected with syphilis and HIV. I think he got infected about eight weeks before we had anal/oral sex the last time. Is it possible that I'm still negative? I've been in the best relationship of my life for the past six months. Only problem: I'm positive, my boyfriend is negative, and he seems to be disinterested in me sexually. Is it the HIV? He claims it might be. What do you think? Cancer and HIV What's the prognosis for a woman who has HIV, hepatitis and was recently diagnosed with breast cancer? I am HIV positive and I was diagnosed with pancreatic cancer. Should I get a second opinion? Will I be able to withstand chemotherapy? I just started a relationship with a young HIV-positive man who also has non-Hodgkin's lymphoma. Can I catch the lymphoma from him? I only had receptive anal intercourse twice many years ago. Should I still get an anal pap smear? Pregnancy and HIV Is an amniocentesis recommended for pregnant HIV-positive women? My wife is currently seven months pregnant. Her doctor has recommended Combivir as a therapy during the last few weeks of her pregnancy. Is this the best route to take? Or would a drug like AZT (zidovudine, Retrovir) or nevirapine (Viramune) be a better choice?		Facial Wasting I've been on meds for six years, five years with efavirenz and Combivir (AZT + 3TC). My CD4 count is 1100 and my viral load blips up and down over the detection limit. I really would like to stop taking my drugs to slow down the steady path towards greater facial wasting. What do you think? Dr. Frascino: I read that you took New-Fill injections to combat facial wasting. How is that working out for you in the long run? Where do I get New-Fill to help my facial wasting? Just wanted to give some feedback about my experience with facial wasting and New-Fill. I experienced severe facial wasting at age 26, which was devastating. I am experiencing facial wasting. What do you think of cheek implants? Lipodystrophy and HAART-Related Rash Why is it that you always say HIV can cause lipodystrophy, while other "experts" point to certain medications as the cause? What is your basis for saying HIV can cause fat wasting and accumulation problems? Almost a week ago, I began treatment with a combination of drugs containing efavirenz. I've been dizzy since I began the regimen. Can you recommend anything to alleviate the discomfort? Fatigue & Anemia My doctor mentioned something about Procrit (epoetin alfa) increasing my testosterone levels and that such an increase in "vitamin T" would lead to more energy. Is this true? On top of my HIV infection, I was recently diagnosed with a rare blood disease and have overwhelming fatigue. My doctor thinks I should have my spleen removed to treat the disorder, but I'm worried a splenectomy might hurt my body's ability to fight off my HIV. Do I have other options? I tested positive in April. I am exhausted and feel depleted of energy. I have also had severe pains in my knees when I sit for long periods of time. One doctor has said that the exhaustion is emotional; another has said that it is a symptom of the virus. What is your opinion?
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