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The Body Covers: CROI 2005, Feb. 22-25, 2004
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March 7, 2005
In This Hot Topics:
  • Starting Treatment
  • Stopping Treatment
  • Living With HIV
  • New Antiretrovirals
  • Other Treatment Questions
  • HIV/HAART-Related Health Problems
  • HIV Transmission
  • Strange but True
  •   STARTING TREATMENT

    Dropping CD4, Low Viral Load: Which Should Determine Whether Treatment Starts?
    My partner is considering starting HIV meds. His viral load is below 3,000, but his CD4 count has dropped from 340 to 325 to 280 in his last three tests. Should he start just based on the CD4 count, even though his viral load is low?


    Is HAART Supposed to Work This Quickly?
    Is it normal to have a response to treatment as fast as mine? I was diagnosed in December 2004 and started treatment on Jan. 8 with a CD4 count of 0 and a viral load of 300,000. I was very scared, but my Feb. 17 tests showed my CD4 count had already jumped to 90 and my viral load had dropped to 1,000!

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      STOPPING TREATMENT

    A Warning: Be Careful When Taking a Treatment Holiday
    This isn't so much a question as it is a warning about taking a break from treatment: I hit the virus hard, and went from a viral load of over a million with a CD4 count of 160 to an undetectable viral load and a CD4 count of 650. I kept it that way for a couple of years with Combivir (AZT/3TC) and efavirenz (Sustiva, Stocrin); things were going so well that I decided to take a break from treatment. I became ill in only three months, and had to restart treatment with a much tougher regimen -- I was even hospitalized due to side effects. It took me a full year to get back to where I was. So my note to everyone is that if you must take a break from treatment, monitor things closely, be prepared to restart quickly, and realize that regaining ground can be a hard path.


    Are HIV Treatment Breaks Foolish or Wise?
    Is it true that once started, HIV treatment can never be stopped? If treatment reduces a person's viral load to undetectable levels, wouldn't the immune system bounce back over time so that you could go off treatment at some point?

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      LIVING WITH HIV

    Will My Doctor Tell My Office I Have HIV?
    I'm HIV positive, but I'm afraid to go to a doctor for treatment, because I worry that the doctor would notify my employer, neighbors, etc. Maybe I'm just being paranoid, but will my doctor make my status known to anyone without my permission? Would he or she be allowed -- or required -- to do that?


    Oral Surgery for the HIV Positive
    I need to have all four of my wisdom teeth pulled within the next year. My CD4 count is around 600 and my viral load is 5,000. Should there be any problems if I have this dental work done?


    SSRIs versus Tricyclics for Depression in HIVers
    I read a recent study that found selective serotonin reuptake inhibitors (SSRIs) may be effective and better tolerated than tricyclic antidepressants in HIV-positive adults. Is this really news? Don't HIV-positive people already use SSRIs?


    HIV+ Woman, HIV- Man: Can We Have a Healthy Baby?
    I will be getting married next year, and my boyfriend and I (he's negative; I'm not) want to have a baby. He knew that I was positive before we met five years ago. My viral load and my CD4 count are both around 500. I've never been on meds because of my good health. Could I have a healthy baby?

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     NEW ANTIRETROVIRALS

    What Does the Future Hold for HIV Treatment?
    How will HIV treatment evolve over the next few years? I've seen a lot in the press of late regarding CCR5 inhibitors; will these replace existing combination therapies, or will they be used in conjunction with current meds? Are they designed for people who have encountered drug resistance, or for people who have never been on treatment? Finally, how far away do you believe a therapeutic vaccine is?


    Should I Start a Phase I Drug Trial if My Lab Numbers Are Strong?
    I was recently infected with HIV, and have the opportunity to do a clinical study of a new type of HIV med, an integrase inhibitor. Phase I of the study would be a 10-day trial in which the integrase inhibitor is the only med I take; in Phase II it would be combined with other meds. Say that my viral load is 50,000 and my CD4 count is 600 when my labs come in. Is it reasonable to think that doing a 10-day trial of this drug could bring my viral load down to undetectable and then allow me stay off meds for months to years? Or would I be better off just staying off treatment altogether?

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     OTHER TREATMENT QUESTIONS

    How Long Can a Successful HAART Regimen Last?
    I've been HIV positive for four years and on meds for 15 months. The treatment has worked extremely well, I've had no adverse side effects, and I'm fit enough to run five to seven miles at least four times a week. When I visited my HIV doc recently, I asked him how long I could continue with my current meds. He said three years (hopefully), and then we'd have to start looking at other combinations. Is this accurate? I mean, I feel great and am nearly 100% compliant. Why would I have to change meds so soon?


    Treatment Makes My Viral Load and CD4 Count Drop
    I've tried two different HAART regimens in the past year. After starting each of them, my viral load quickly became undetectable, but both times my CD4 count also dropped by at least 100. Is this a normal phenomenon? Any suggestions on how to boost my CD4 count without stopping my meds?


    Concern Over ddI + Tenofovir Interactions
    I'm taking Kaletra (lopinavir/ritonavir), ddI (didanosine, Videx EC) and tenofovir (Viread). I've seen studies that show that blood levels of ddI and tenofovir may increase with this combination. Should I change either my dosing schedule or my food intake to account for this?
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      HIV/HAART-RELATED HEALTH PROBLEMS

    Shrinking Testicles on Testosterone Treatment?
    I've been taking AndroGel (a testosterone supplement) for nearly a year and a half, and over the last several months my testes have not only significantly shrunk but also lost much of their mass, firmness and form. Before beginning the therapy, my doctors would regularly comment on my prominent testes. But during my last two visits, my urologist not only noted the reduced size and mushiness of my testes but also the prominence of the cords (epididymis) and how he could move the testicular mass around in the pouch, which apparently has not shrunk. Is this a normal result of testicular atrophy? Can anyone predict how much the testes will collapse? Will they ever return to their former selves?


    Getting Help for Fatigue
    My friend suffers from fatigue all the time. She's taking atazanavir (Reyataz), ddI (didanosine, Videx), ritonavir (Norvir) and tenofovir (Viread), has an undetectable viral load, a CD4 count in the 600s and no other symptoms. Is there anything she can do about the fatigue?


    What Do I Do if I Have Dementia?
    Over the past few weeks, I've started experiencing what I've been told is dementia. Neither of my HIV doctors will tell me what the outcome will be or how I should prepare for what is about to happen. Can you tell me what I should expect? My will is in order and a very good bottle of Scotch is on hand. My question is, how will I know when to break open the cap?

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      HIV TRANSMISSION

    Can Slow Progressors Still Infect Other People?
    Today I went to an HIV specialist for the first time since I was diagnosed over two years ago. My viral load is still undetectable and my CD4 count is 1,069. The doc looked over my lab results and told me that he thinks I am a non-progressor. If that's the case, is it still possible for me to pass HIV to others? I still, and will always, practice safe sex, but I would like to know what the odds are of me transmitting HIV to someone else.
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      STRANGE BUT TRUE

    Close Encounters of the Love-Doll Kind
    I bought a love doll on eBay, and after I used it, my groin area became brown and itchy. The doll was advertised as new, but I read the online feedback from other people who had bought one, and 10 of the 2,500 people giving feedback said the package was slightly open when they received it. The doll also came with a generic package of lube, which I'm worried might have had HIV in it. My doctor said that the browning and itchiness was caused by a fungus, which cleared up after she gave me meds. But could I have gotten HIV from the doll or the lube? Could HIV survive in the lube during the 10 days it took the doll to arrive, and the four extra days that went by before I used it?
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    Art From HIV-Positive Artists
    Image from the March 2005 Visual AIDS Web Gallery
    "Higher Learning," 1999;
    Raymond Bordeaux
    Visit the March 2005 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists!

    Your Unused HIV Meds
    Can Save Lives!

    AID FOR AIDS

    AID FOR AIDS is a New York-based nonprofit organization that collects unused, HIV-related medications and redistributes them to people living with AIDS in Africa, the Caribbean and Latin America.

    Have HIV-related medications (including antiretrovirals and meds used to prevent or treat opportunistic infections) you'd like to donate? Click here to find out how.