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Ask the Expert Hot Topics
August 19, 2003

Check out these hot topics at The Body's Ask the Expert forums:
HIV and the Workplace My employment health form asked me what meds I'm on. I omitted my HIV meds, so technically I lied on the form. Have I made a mistake by not disclosing? I was recently laid off and am looking for a new job -- but not a new health plan, since I already have an excellent one with a private company. When I find a new job, do you think my new company would be willing to give me cash instead of paying for my membership in its healthcare plan? HIV/HAART-Related Health Problems My insurance ran out. Do you have any ideas how I can get Procrit? I don't have any money to pay for it. When I was diagnosed with HIV on May 30, my testosterone was down to 182 (it had been 544 a year earlier). It went down to 170 a month later. My new doctor prescribed Testim, an alternative to testosterone shots or AndroGel. Can you tell me more about it? I switched from AZT (zidovudine, Retrovir) to tenofovir due to lipoatrophy. I am now on 3TC (lamivudine, Epivir), abacavir (Ziagen), nevirapine (Viramune) and tenofovir (Viread). Should I expect an improvement in my face? My doctor has also tried putting me on rosiglitazone, 4 mg/day. I've been on this for about five months but haven't seen any improvement. I take Combivir (AZT + 3TC) and efavirenz (Sustiva). Should I stop the AZT and switch to 3TC, abacavir and efavirenz in order to reverse my lipoatrophy and gynecomastia? What can you tell me about RU-21? It's distributed as a dietary supplement and is supposed to prevent liver damage. Could it also help curb the damaging effects of HIV meds? I've just restarted HAART with Combivir, efavirenz and tenofovir. Prior to starting HAART I had insomnia, and now that I've started taking efavirenz it has worsened. I've used Ambien, Sonata and Lorazepam to help me sleep, but unfortunately they don't work for me anymore. Can you recommend anything to get past the insomnia? I'm also suffering from depression, but I'm scared to take anything for it. Questions on HIV Treatment I've gone five years without treatment, and in the last nine months my CD4 has risen from 860 to 1340 and my viral load has dropped from 15,000 to 3,000. Could I be a "long-term non-progressor"? After five years of being HIV positive, the time has come to start treatment. My doc has decided to use tenofovir, 3TC and nevirapine. Is this a reasonable and durable first-round treatment? So far the side effects have been minimal and there have been no interactions with concurrent meds. I recently had a bad conversion illness which included cryptosporidiosis. My HIV antibody test was negative, but the doctors did a viral load test which came back positive. They started me on Combivir and efavirenz, but I keep reading about NOT starting right away. I am 20 years old and want to live a long time. Was it wrong to have started on meds so early?		Living Well With HIV I recently asked my doctor about my life expectancy now that I am HIV positive. He said it's kind of like a clock; once the meds are started, the clock stops ticking and I'll have a normal life span. Would you agree? To say that starting HIV meds is like stopping the clock of disease is outrageous. Don't you realize that liver failure is now the number one killer of HIVers on the meds? I've had HIV for at least eight years and have been on meds for about four. I've done my best to maintain a good attitude. I've told close friends and a couple of family members; kept working full-time; and sought help for depression, peripheral neuropathy, digestive problems, eye ailments and other side effects. I'm currently on AZT, abacavir, efavirenz and an array of treatments for my other health problems. Any ideas on how to keep my attitude positive? Although I was diagnosed in 1990 and have been hospitalized three times, my health has dramatically improved since I started combination therapy in 1995. I'm 53 years old, with a CD4 count of 700 and an undetectable viral load. I've been taking Prozac for 10 years, but I've lost my "joie de vivre" and my energy level is low due to the medications. The bottom line is that I'm retired, poor and gay -- it ain't pretty. Any ideas on how to be more hopeful? HIV/STD Transmission Many of us in the gay community feel that if you're always the one on top, your risk of getting HIV from unprotected insertive sex is virtually non-existent. What are your thoughts? And does the use of HAART make unprotected anal sex safer? While out with my wife one evening I was attacked by a mugger who looked like a drug user. To make a long story shorter, I bit the attacker to avoid being choked. I got a lot of blood in my mouth. I got a sore throat two days later and a doctor gave me a penicillin injection for laryngitis. I had five PCRs and ELISAs within nine weeks -- all negative. Am I one of those people who is infected, but has an undetectable level of virus because my body is able to control it? I'm in law enforcement. Not long ago I was on duty at a club in a high-risk area for HIV where I punctured my leg on a nail that appeared to already have someone else's blood on it. What are the odds I'm positive?
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