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Ask the Expert Hot Topics
December 8, 2003

Check out these hot topics at The Body's Ask the Expert forums:
HIV/HAART-Related Health Problems Do you think my life expectancy will be shorter than other people with HIV since I already had AIDS when I was diagnosed? (I had PCP, a CD4 count of 50 and a viral that was load off the charts.) By the way, I'm doing well now and responding to treatment. I just read that people with HIV are more than twice as likely to have an allergic reaction to antibiotics as HIV-negative people. Is this true? Are standard anemia tests accurate? The reason I ask is that although my doctor said the tests indicate I am not anemic, I experience fatigue a lot, my mother was anemic, and I was once diagnosed as anemic by an "alternative practitioner" who tested me in her office. For the last nine months, I've been taking 4 mg of rosiglitazone (Avandia) for facial lipoatrophy. I have not seen any improvement -- maybe a slight worsening, in fact. The meds I am on are the friendlier ones: abacavir (Ziagen), tenofovir (Viread) and nevirapine (Viramune). Could the rosiglitazone be making my lipo worse? Dear Dr. Wohl: You told someone who wrote in concerning his facial and extremity wasting that you suspect it was due to fat loss. I disagree! When people have severe wasting of the extremities, it is because of loss of muscle tissue! I recently developed a severe case of pancreatitis, complete with diarrhea, severe abdominal pain and weight loss. I also seem to have a lack of circulation in my feet. I have been HIV positive since 1998, my viral load is undetectable and my CD4 count is 470. In addition to my HAART regimen -- 3TC (lamivudine, Epivir), abacavir (Ziagen), efavirenz (Sustiva) and tenofovir (Viread) -- I take blood pressure meds for cholesterol, megestrol (Megace) for increased appetite, and a water pill called triamterene (Dyrenium). My doctor wants to hospitalize me, put me on IV fluids and stop my meds so my bowels can have a rest. What do you think? Safe Sex & HIV Transmission My girlfriend is allergic to latex, so we can't use a condom. What other protection is there? Are lambskin condoms effective at preventing HIV? There's a very small warning label on the package that says they don't offer disease protection, but I have a theory that the actual risk of transmission is negligible.		Questions on HIV Treatment Assuming no drug resistance, what regimen would you recommend for a treatment-naive person who has a low viral load, has a tendency toward bad nausea and diarrhea, has low normal hemoglobin and red blood cell counts, and who is very viremic (sore throat, tender glands in throat and groin, nausea, weak legs and periodic numbness in toes, feet and face)? I just changed my treatment to nevirapine (Viramune), once-a-day ddI (didanosine, Videx EC) and tenofovir (Viread). My doctor said I can continue to take my combination once a day with a meal. However, everything I read says I should not take the once-a-day ddI and tenofovir together, and that once-a-day ddI should be taken on an empty stomach well before or after a meal. I'm so confused about what to do! I was recently diagnosed and, in my attempts to learn as much as I can about HIV, read some of the "AIDS mythology" sites, which preach that HIV doesn't cause AIDS and that antiretrovirals are deadly. I noticed that much of the info on these sites was from the early- to mid-1990s and that the biotech industry has made incredible strides since then. Has modern science conclusively refuted AIDS mythologists' assertions? Complementary and Alternative Therapies I need to gain weight and was wondering if you have any high-calorie suggestions that I don't have to cook. Currently, I have four Ensure Plus drinks (350+ calories each), four devil dogs and two Snickers bars (720 calories) and two bowls of pasta every day. What daily dosage of vitamin E and other vitamins would you recommend for an HIV-positive person? Strange but True Instead of using a condom, I wrapped my penis in a plastic grocery bag before having sex with a woman. Do you think it wasn't enough protection? I took a girl's underwear out of a clothes dryer and masturbated with it. The CDC told me I need a therapist, but isn't there a chance I may have been infected?
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