June 29, 2009
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Renslow Sherer, M.D.EXPERT RETURNS TO THE BODY'S "ASK THE EXPERTS" FORUMS


Renslow Sherer, M.D., is back at The Body's "Ask the Experts" Forums! After a brief hiatus, the forum on Drug Resistance and Staying Undetectable is up and running again -- and Dr. Sherer is on the job, answering questions about avoiding HIV drug resistance and keeping an undetectable viral load. Dr. Sherer is one of the leaders in the treatment of HIV -- not only has he been treating people with HIV since 1982, he's also an active researcher.


Also Worth Noting: New Blog: River Huston Writes About HIV and Body Image

HIV Retreats

"The first thing I did after I found out I was HIV positive was eat. I decided that if I was going to die, I was going to die fat. F*ck 'em, I thought; let 'em buy an extra large coffin." When she was diagnosed -- during the years before good HIV treatment was available -- TheBody.com's blogger River Huston decided that she didn't want her last meal to be Egg Beaters. Now, more than 15 years later, River has not only survived, but she's beaten her body image problems.
LIVING WITH HIV


 How Can a Baby Born With HIV Test Negative Two Years Later?
I was just watching The Tyra Banks Show. A woman on the show said her mom adopted a child that was born with HIV, but then tested HIV negative at the age of two. How is this possible?


 Any Advice for Someone Newly Diagnosed With a Low CD4 Count?
I'm a male in my mid-20s. I was diagnosed with HIV on June 2, 2009. For most of the month, I experienced symptoms common for seroconversion. I met my infectious disease specialist today -- my CD4 count is at an apparently troublingly low level of 240, and my viral load was 130,000. I have yet to take any HIV meds but my doctor prescribed Atripla (efavirenz/tenofovir/FTC). I'm trying my best to keep my head up and all, but my lab results are scaring the hell out of me. Any general advice or pointers?


HIV TREATMENT


 Using Isentress in an Innovative Way to Lower Viral Load
I was infected and diagnosed three months ago. My CD4 count is 500 and my viral load is over 500,000, which I've heard is normal for a new infection. I decided to start meds earlier rather than later after weighing the pros and cons. I'm on Atripla (efavirenz/tenofovir/FTC) and Isentress (raltegravir). My doctor is hopeful that I can wean off Isentress after my viral load comes down. Is this strategy normal? How soon can I expect my viral load to come down?


 CD4 Count Low: What Multivitamins Do You Suggest?
I was diagnosed with HIV in January 2009 and my CD4 count is 238. I was told that my CD4 count is not low enough to start treatment and that I should just take care of myself to try and boost it. I'm currently taking vitamin C and vitamin B complex. Is there any other supplement you'd suggest I take, besides what I'm currently getting from the clinic?


 How Can You Have Resistance to a Drug You've Never Been On Before?
I am 22 and I was recently diagnosed with HIV. The specialist got the resistance tests back and it turns out that both my fiancée's HIV and mine have drug resistance to NNRTIs (non-nucleoside reverse transcriptase inhibitors, or "non-nukes"). This changes our treatment options. How does this resistance occur when I've never taken any HIV medications before? Also, I need to take something to prevent PCP (pneumocystis pneumonia) but I'm allergic to Bactrim (co-trimoxazole) and dapsone (Avlosulfon) so I have to have intravenous treatment for PCP. Is this just as effective?


SIDE EFFECTS & OTHER HEALTH ISSUES


 Sexual Dysfunction After HIV Diagnosis
I was diagnosed HIV positive at the end of March. I have been taking Atripla (efavirenz/tenofovir/FTC) for almost a month with no side effects that I can discern. My problem is one of erectile dysfunction that has manifested since my diagnosis. I'm a 60-year-old married man; my wife, who is HIV negative, is very supportive and we have an excellent relationship and a healthy sex life. Before this, I was like the Energizer bunny, able to almost get an erection on demand; now every attempt at intercourse just ends as an exercise in frustration. What can I do about this problem? My wife says it's in my head, and I tend to agree.


Also Worth Noting: HIV Retreats: A Little-Known Way to Meet Other HIVers

HIV Retreats

Are you looking to connect with other HIV-positive people in a supportive environment? One option is to go on an HIV retreat. Retreats range from carefree holidays to educational weekends. There are retreats beachside, in the mountains and in the middle of the biggest U.S. cities. They're geared for the newly positive as well as longtime HIVers just looking for a chance to unwind. Many retreats are free, low-cost or provide discounts to people in need.
 Hepatitis C in Semen?
Does hepatitis C reside in the semen? Is there a significant risk to receptive anal sex partners if the insertive partner has hepatitis C?


 Atripla and Pre-Existing Depression
I've been taking Atripla (efavirenz/tenofovir/FTC) for one week (my first-ever HIV meds) and have become depressed. About three years ago, I suffered from depression and was treated with cognitive behavioral therapy and citalopram (Celexa), which I still take. The treatment worked and I have had no depression for over two years. I know that Atripla can be associated with depression. Is it likely that the depression will disappear soon as I get used to Atripla? Should I look to change to another HIV combo or increase my dose of citalopram?


 Can Marijuana Help Decrease HIV Med Side Effects?
I've noticed that smoking marijuana greatly reduces the side effects associated with my HIV medications. Is this common with other HIVers? I casually mentioned this to my doctor and even inquired about obtaining it for "medicinal" purposes. My doctor wasn't sure that it was indicated for medicinal purposes in HIV-positive people and dismissed the topic. Do you think it is indeed indicated in HIV disease, and if so, what channels would I take to get it? I am in Canada, and the rules may be different from those in the U.S.


 Do You Think Retin-A Would Be Good for Residual KS Scarring?
I had Kaposi's sarcoma on my leg that has been clearing up with HIV treatment, but it appears to be a really slow process. Could Retin-A (tretinoin topical) cream help this process along?


HIV & BODY SHAPE CHANGES


 When Might Tesamorelin Be Approved for Fat Accumulation in HIV-Positive People?
My belly is big with intra-abdominal fat without subcutaneous fat. I know that the only treatment for it, tesamorelin, is close to approval and that an application was submitted to the U.S. Food and Drug Administration on June 1. If it is found to be safe and effective, when might it be approved? Are there still any studies on it in which I would have a chance of getting the medication (instead of the placebo)?


 Fillers for Lipoatrophy Around the Eye?
I've been experiencing facial wasting and the place I have been losing more fat than anywhere else on my face is under my eyes. My plastic surgeon told me he doesn't treat the area around the eyes in the case of lipoatrophy because it's "too dangerous." Is this true -- even with Sculptra (poly-L-lactic acid, New-Fill) and Radiesse (calcium hydroxylapatite, Radiance) injections? Is there anything that can be done?


 When Will I See the Full Results of My Sculptra Treatments?
I had five rounds of Sculptra (poly-L-lactic acid, New-Fill) four years ago. It did pretty well but now I need a touch up. I already had one visit where I had two vials of Sculptra injected and am planning on two more visits with one vial each visit. How long does it take for the final results to show up?


Also Worth Noting: Connect With Others
Newly Diagnosed and Told I Have Highly Resistant HIV
(A recent post from the "I Just Tested Positive" board)

It's been a month since I found out I'm positive. I just found out my lab results yesterday and they show that I have a highly drug-resistant form of HIV. I am just looking to hear from others who have a highly resistant strain. I am on five meds, might be adding a sixth. What an emotional roller coaster the last month has been ... Vacation cannot come soon enough!

-- BeerMe30

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HIV TRANSMISSION


 Is There Such a Thing as HIV Immunity?
I am a 43-year-old gay male and I have been having sex with men for around 25 years. I know this is not something to put lightly, but I have had unprotected sex with at least 80 men. I even had a lover of five years who was HIV positive and we never used condoms. I am NOT bragging, but wondering why and how I am still HIV negative. I know what I am doing is wrong, but could there be something about me that keeps me HIV negative? I take an HIV test every six months at my local health department and it has always come back negative.


 Is It Recommended to Use a Latex Condom With a Female Condom?
Would it be safe for me to wear a well-lubed condom (say, lubed with silicone oil, which does not dry out like water-based lubes) in conjunction with my girlfriend using a female condom? Or does this scenario share the same drawbacks as double-bagging (i.e., using two condoms)?


STRANGE BUT TRUE


 Can You Get HIV From Nose Secretions Mixed Into Food?
A friend of mine who is HIV positive was eating spicy food, and his nose was running. He used his left-hand finger to clear his nose, and used the same left hand to take the curry from the bowl with a spoon. Afterward I used the same spoon to take curry. If his nose fluids fell into the curry bowl and I consumed some of it, would I be at risk for HIV? Should I get tested? Please answer, I am very worried over this incident.






Activist Central

 Take a Survey Addressing the Vocational Needs of HIV-Positive People


 Write to District Court Judge Bradley J. Harris, who sentenced a man to 25 years for not disclosing to another man he was HIV positive.


 Tell Congress to Make Health Care Reform Work for People With HIV/AIDS!


 Tell Abbott That We Will Not Accept a High Price for Their New Norvir!


 Tell CVS: Don't Restrict Access to Condoms!


 Endorse the International Declaration on Poverty, Homelessness and HIV/AIDS


 Speak Out Against the Syringe Funding Ban!


 Write a Letter to President Obama to Support the Action Plan for Rapid Scale-Up of Routine, Voluntary Testing


 Give Our Youth the Facts! Tell your senator to co-sponsor the REAL Act.


 ART Initiation at <350 -- Call on WHO and UNAIDS to Save Lives!


 Volunteer at a Camp for HIV-Affected Kids


 Congratulate Obama ... And remind him of his commitment to a National AIDS Strategy!