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Ask the Expert Hot Topics
October 20, 2003

Check out these hot topics at The Body's Ask the Expert forums:
"Ask the Experts" en Español Know someone who needs HIV information in Spanish? We have three HIV specialists available to regularly answer questions from Spanish speakers! ¿Tiene preguntas sobre su tratamiento de VIH/SIDA? Doctores especializados en VIH/SIDA estan disponibles a responder en su propio idioma a todas sus interrogantes. Mental Health and HIV I just found out about my status, and as you might imagine I feel quite lost. I'm 36 years old and afraid that now I won't be able to find a companion. My sex drive is low and I wish I could be back to my normal self. What can I do to be as close as possible to feeling normal? Understanding Your Labs Any idea what's causing these jumps in my CD4 count and viral load? I was infected with HIV last December and I'm not on treatment. My CD4 count bounces from 700 to 900 and then back again, while my viral load goes back and forth between undetectable and 200. My doctor says my numbers are really good for the first year of being HIV positive. After a treatment interruption, I started taking nelfinavir (Viracept), nevirapine (Viramune) and tenofovir (Viread). In the last eight months since restarting treatment, my viral load has vacillated between 6,000 and 25,000, while my CD4 has stayed at about 480. My doctor says this is not a big concern. What do you think? Complementary Therapies What kind of impact will the Supreme Court's decision to allow doctors to talk to their patients about using medical marijuana have on its use in the U.S.? Safe Sex & HIV Transmission A couple of weeks ago, my partner revealed that he is HIV positive. He is a "long-term non-progressor." What sexual practice is considered risky for us? Are there any programs in Sydney that can help mixed-status couples? Strange but True Can HIV "run" up a stream of sperm? I masturbated into a sock and am worried it may have climbed from the sock through my semen and into my penis.		HIV/HAART-Related Health Problems How do I balance the odds of developing a severe negative reaction to HIV meds against the likelihood of developing opportunistic infections without the meds? Dr. Pierone, you recently answered a question about wasting in which you mentioned that you sometimes prefer alternative treatments. Could you talk about them? I began an HIV treatment regimen in March 2003 that includes d4T (stavudine, Zerit). I have seen no signs of lipodystrophy so far. Do all patients taking d4T develop butt wasting and other forms of lipodystrophy? How long before the symptoms show up? Thanks to my HIV meds I'm still alive and well (undetectable viral load, 860 CD4 count), but now my labs show I may be developing diabetes. What can I do to stay healthy? Questions on HIV Treatment My salary is only $12,000 a year and I have no insurance. Is there any way I can pay for my HIV medicines? Should I be worried about developing fat problems while on Kaletra (lopinavir/ritonavir), even though I'm doing well on it after four weeks? I'm also concerned that if I use Kaletra now I may not be able to use it later; another doctor in these forums said that he uses it only for salvage. What do you think? I'm interested in adding efavirenz (Sustiva) to my Trizivir (AZT + 3TC + abacavir)-only regimen so it'll become more potent, but my doctor says I'm doing fine on Trizivir alone. Shouldn't I add efavirenz just to be safe, even though my viral load is undetectable and my CD4 is going up? After I was diagnosed in 1997, my doctor put me on 3TC (lamivudine, Epivir), d4T (stavudine, Zerit) and nelfinavir (Viracept), but changed my cocktails in 2002 due to side effects. He switched me to Trizivir (AZT + 3TC + abacavir) alone, which did not work that well. He then added nevirapine (Viramune) and later switched that to efavirenz (Sustiva). My viral load soon rebounded, though: It's now at 1,100, so I am having a genotype resistance test done. I assume he'll want to put me on a boosted protease inhibitor and whatever NRTIs I'm not resistant to (if any). Do you have suggestions on which cocktail might be better for me?
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This article was provided by TheBody.com.

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