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June 21, 2004
In This Hot Topics:
  • HIV Treatment Questions
  • Drug Resistance & Treatment Options
  • HIV & the Workplace
  • Facial Wasting Treatment
  • Mixed-Status Relationships
  • Nutrition & Quality of Life
  • HIV Transmission
  • Strange but True

    Adherence Tips for Those Sick of Meds
    I've been on my current regimen since 1998 and I feel great, but it gets tiresome having to take so many pills. I'll do terrifically for a few months, but then slip and miss a few weeks. Why is it so difficult for me to make a habit of taking those darn pills? Got any helpful tricks?

    A Good First-Line Regimen?
    I just started treatment for the first time with a once-a-day combination of efavirenz (Sustiva, Stocrin), FTC (emtricitabine, Emtriva) and tenofovir (Viread). Is this an effective combination to take, given that I have no drug resistance?

    Stopping HAART During Hospitalization
    My partner, who was recently diagnosed with AIDS, was hospitalized with a very high fever shortly after starting his first HAART regimen (3TC [lamivudine, Epivir], abacavir [Ziagen] and efavirenz). His CD4 count is only 37 and his viral load is over 500,000. Fearing abacavir hypersensitivity reaction, his doctor stopped his HAART regimen and, after treating him with steroids and some other meds, he's been doing much better. It's been two weeks now since my partner stopped his HIV meds; why can't he restart them if he's doing well? I'm worried about his low CD4 count and high viral load.

    Switching Kaletra for Atazanavir?
    I've been on six different HAART regimens, the latest of which has raised my liver enzymes and failed to lower my viral load level below detection. I'm taking four meds: 3TC, d4T (stavudine, Zerit), efavirenz and Kaletra (lopinavir/ritonavir). My doc wants to switch the Kaletra for atazanavir (Reyataz). Do you think that'd be a good move?



    Should PI Resistance Keep Me From Starting HAART?
    I was infected a year ago with a strain of HIV that's very resistant to protease inhibitors (PIs). My viral load is 150,000, but my CD4 count is 430, and a resistance test found that my virus' replication capacity was only 30%. Should I start treatment, or should I wait as long as possible since I'm already resistant to PIs?

    An "Unphenotypable" Virus
    Doctors say my HIV is "unphenotypable" -- that there's no way they can perform a phenotype resistance test on it to determine what HIV meds I'm resistant to. What does this mean, and why is it happening?



    More Info on HIV and Security Clearance

    I have some followup information for the person who recently asked about U.S. security clearance for people with HIV: You won't be required to divluge your HIV status in order to obtain or maintain top-secret clearance. What can disqualify a person, though, is a history of treatment for depression (common among HIVers) or excessive debt (also common if one has had to pay out of pocket for HAART).

    Click here to see the original f
    orum post referred to above.

    Disclosure Requirements for Nursing Students
    I'm an HIV-positive college student hoping to become a nurse. Do I have to disclose to the nursing program I apply to?


    No Luck With New-Fill? It May Be the Collagen
    I have a word of caution for those who are considering New-Fill. I went through six unsuccessful treatments before learning that New-Fill is less likely to work for those who have been previously treated with collagen injections. On the plus side, though, I finally turned to SilSkin (a silicone injection treatment not yet approved by the U.S. government) and had fantastic results.

    One Has HIV, the Other Hepatitis
    I'm falling head over heels for this guy I recently started dating, but he tested positive just a few weeks after we met. I'm HIV negative, but I have hepatitis B, so I'm concerned for both of us. What do we need to know about safe sex and transmission risk?

    Dating Someone With HIV? You're Not Alone
    I think I've just met the guy, but he has disclosed that he's had HIV for more than 20 years and is a hemophiliac. He's very healthy and has an undetectable viral load. I'm nuts about him, but would pursuing this relationship be an insane idea? How many other couples are in our situation?

    Diet Tips for Those With High Triglycerides/Cholesterol
    I have extremely high levels of cholesterol and triglycerides. My doctor wants me to go on a no-fat, no-carb diet. Can you suggest a diet plan for me?

    Safety of Dental Implants?
    Can dental implants be successfully placed in HIV-positive people? I can't find any reliable studies that have shown whether dental implants are a health risk.

    Getting HIV From a Dentist's Tools
    Can I become infected with HIV if the tools my dentist used weren't cleaned?

    HIV and the Rented Tuxedo
    While picking a tuxedo rental that had been altered, I accidentally pricked myself on a pin that was stuck through the collar. If someone with HIV also pricked himself on it, could I have been infected?

    Ask Dr. Holodniy About:

    Dr. Mark Holodniy

    Making sense of your lab test results can often be a challenge. Dr. Mark Holodniy is here to help -- he staffs our "Ask the Experts" forum on Understanding Your Labs. An experienced HIV physician and researcher, Dr. Holodniy is the director of the HIV Clinical Program and AIDS Research Center at Veterans Affairs Medical Center in Palo Alto, Calif.

    Image from the June 2004 Visual AIDS Web Gallery
    "It Is Beautiful There," 1992;
    Arnold Fern
    Visit the June 2004 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.