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January 26, 2004
In This Hot Topics:
  • HIV and the Workplace
  • AIDS-Related Dementia
  • HIV Medications and Pregnancy
  • Sleep, Fatigue and HIV
  • Anemia and HIV
  • Starting HIV Treatment
  • Living With HIV
  • HIV Transmission
  • Strange But True

    Cashing in Your IRA
    Can I cash in some or all of my IRA without penalty? I'm a self-employed person with AIDS and hepatitis C.

    Insurance Options When Long-Term Disability, ADAP Aren't Possible
    I'm a healthy poz guy who has no plans to go on disability any time in the near future, though I'm concerned I might have to down the road. My employer does not cover me for long-term disability, so if this happens I would be forced to go on SSDI; I would not be eligible for ADAP because of my financial situation. How do people pay for expensive drugs if they're on SSDI and don't meet the requirements for ADAP? Since my state allows my domestic partner to include me in his coverage, should I take advantage of that instead?

    Insurance Issues for Entrepreneurs
    I am an HIV-positive female in a troubled marriage and trying to plan my future. I am considering starting a small business -- particularly because of my age and background, which make finding a job with insurance difficult -- so I would have something of my own if I got a divorce. Would health insurance issues make small business ownership unreasonable? Right now I have good PPO coverage through my husband's company.


    Determining if You Have Dementia
    I have a growing concern that I suffer from HIV-associated dementia, based on descriptions I've seen in these forums. What type of healthcare professional should I seek out to evaluate this?

    HAART and the Blood-Brain Barrier
    I have had HIV for more than 20 years, since late 1982. I have heard that the rate of AIDS-related dementia is about 10 percent for people on today's new treatments, though I assume that's only if people take drugs that pass the blood-brain barrier, such as AZT (zidovudine, Retrovir). Can you tell me if I am at risk of developing dementia with my current regimen: 3TC (lamivudine, Epivir), ddI (didanosine, Videx) and Kaletra (lopinavir/ritonavir)?


    Is 3TC/Nevirapine/Tenofovir Dangerous?
    I was on 3TC (lamivudine, Epivir), nevirapine (Viramune) and tenofovir (Viread) before I knew that I was pregnant. My doctor has changed my meds now, but I'm very concerned about the meds I was taking during my first few weeks of pregnancy. Is my baby going to be OK?

    Does Efavirenz Pose a Risk During Early Pregnancy?
    For the first 14-20 days of my pregnancy I was taking efavirenz (Sustiva). I've stopped taking it, but I'm terribly scared that my baby might still be deformed or have health problems because of the few weeks I was on it. Could you tell me if my baby might have birth defects?

    Inexplicable Exhaustion, "Heavy Head"
    Lately, some mornings I can barely lift my head off of the pillow. My head feels so heavy and hurts so bad, it feels as if it's going to explode. On weekends, I get up, prepare breakfast for my kids and then find myself in the bed again until my children wake me for lunch. I thought perhaps I was depressed, but I'm not experiencing any kind of mental stress. The doctor drew blood and found my labs were normal. I've been HIV positive since 1997. I'm on medications; my viral load is undetectable and my CD4 count is 897. Any guess as to what's going on with me?

    Recommended Hours of Sleep for HIVers
    Does sleeping only six hours instead of nine or more make any difference for someone living with HIV?

    Severe Anemia and AZT Switching
    Because I'm on chemotherapy for my Kaposi's sarcoma, I'm severely anemic, even though I'm being treated with epoetin alfa (Procrit). I'm currently on my first regimen (Combivir [AZT + 3TC] and efavirenz [Sustiva]); although I can't be sure the AZT (zidovudine, Retrovir) is causing my anemia, I know it is known to do so. Do you have any information about when abacavir (Ziagen) and 3TC (lamivudine, Epivir) will be available as one pill, so I can discontinue the AZT?

    Low Blood Labs and Shortness of Breath
    Many of my blood tests -- hematocrit, hemoglobin, red blood count -- have been consistently in the lower end of the spectrum. Does that make me mildly anemic? I have also been experiencing shortness of breath while exercising. I'm an ex-smoker, so my doctor ordered pulmonary function tests to see if emphysema may be responsible for the shortness of breath, but the tests came out normal. What are your thoughts?

    When Viral Load Remains Detectable
    In mid-October I started treatment with Combivir (AZT + 3TC) and Kaletra (lopinavir/ritonavir). When I started, my CD4/percent/viral load was 290/19/150,000. About two-and-a-half weeks into treatment they changed to 400/19/900. My viral load doesn't appear to have changed much at all since then. Is this bad? How quickly should it become undetectable?


    Supplements for Healthy HIVers
    Could you suggest a good nutritional supplement for someone like me? I'm a 36-year-old man who's had HIV for six years, but is otherwise healthy. My weight is average, I don't smoke and I do a cardiovascular workout three times a week. I was only on HIV meds for the first three years after my infection; my CD4 is now 800 and my viral load is 25,000.

    A Test for HIV Nonprogressors?
    I've been told I'm a "long-term nonprogressor," but are there any tests that can confirm this?


    Repeated HIV-Negative Tests Despite Unprotected Sex
    My husband has been HIV positive since 1999. We got married in 2003 and have been having sex without a condom, but my HIV tests keep coming out negative. How is that possible?

    Dr. Bob, How Were You Infected With HIV?
    Editor's Note: It is well known that our fatigue/anemia and safe sex expert, Dr. Bob Frascino, was infected with HIV through a needlestick accident. Because he's gay, however, some readers of his forum have doubted this, and have recently expressed their doubts on a question-and-answer Web site run by Johns Hopkins University. Dr. Joel Gallant, a prominent HIV physician who was formerly an expert at The Body and now staffs the Johns Hopkins Q+A site, responds to these doubts.

    The Risks of Keeping Your Eyeballs Bare
    I work in an office with a gay guy (I know this doesn't mean he is positive). Two months ago, he had a cold sore on his lip and it was bleeding. I didn't realize this until he approached my desk to ask a question. I noticed the blood and tried to avoid eye contact with him. My fear is that during our conversation a tiny speck of his blood may have fallen into my eye. How can someone who plays it so safe be placed in a predicament like this? Would a three-month test be conclusive? If all goes well, I guess I'll have to start wearing glasses.
    Image from the December/January Visual AIDS Web Gallery