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March 21, 2005
In This Hot Topics:
  • Living With HIV
  • Starting Treatment
  • Drug Resistance
  • HAART Side Effects
  • HIV-Related Health Problems
  • Hepatitis C & HIV
  • Women, Children & HIV
  • Strange but True
  •   LIVING WITH HIV

    Sex and the Positive Man
    I'm an HIV-positive gay man who's concerned about preventing the further spread of the virus. I'm 28 years old, successful and attractive. I recently moved from a small town to one of the country's biggest cities, and there's no shortage of men showing interest in me. In the year that I've been here, I've dated two decent guys, but both of them hit the door running after I revealed my status (before we became sexually active). If I meet someone who's willing to stick it out, someone who's going to trust me to keep him safe, what exactly are our limits? What can and can't I do?


    Are Illegal Drugs the Norm for East Coast Gay Men?
    Since my HIV diagnosis nine years ago, I've often gone through periods of isolation. Now I'm 34, very healthy and trying diligently to get out and socialize more, meet people online for coffee dates, go to support groups when I can, etc. I'm also in therapy once a week. On my re-entry into the gay world I've found that in bars, clubs and fundraisers in Boston and New York City, many guys seem to be under the influence of something more than a few stiff cosmopolitans. They have a wide-eyed, dilated look. Is everyone on stimulants these days? This scares the crap out of me, since it also seems to be an accepted norm in gay culture. Is this as prevalent as it seems to be, or am I overreacting?


    A Holistic Take on HIV Treatment: Smoking, Lifestyle and Nutrition
    Is there a holistic way to keep my viral load down and my CD4 count up? I'm a recovering addict who also needs to quit smoking, but otherwise I'm in good health: My CD4 count is 680, my viral load is 16,000, I take a multivitamin and eat a lot of fresh fruit and veggies. I've been told I shouldn't try to quit smoking until I've been in successful recovery for a year, but should I let my health wait that long?


    Donating Your Body to Science
    I'm a long-term HIV survivor, but I was wondering: How can I find out if there are any medical organizations I can donate my body to when it's my time to go?
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      STARTING TREATMENT

    Is This an Unusual First-Line HAART Regimen?
    A friend was recently prescribed what seems like an unusual first-line HAART regimen: fosamprenavir (908, Lexiva, Telzir), FTC (emtricitabine, Emtriva), ritonavir (Norvir) and tenofovir (Viread). I know that the gold standard when starting treatment has been Combivir (AZT/3TC) + efavirenz (Sustiva, Stocrin) or Kaletra (lopinavir/ritonavir); why wasn't he prescribed one of those two regimens instead? He has a viral load of about 400,000 and a CD4 count of 200.


    Freaking Out About My First HAART Regimen
    Since being diagnosed with HIV three weeks ago, my blood tests found that my CD4 count is 232 and my viral load is 172,000. My consultant -- I live in the United Kingdom -- recommends that I start treatment as soon as possible, which is freaking me out. He's suggested a combination of 3TC (lamivudine, Epivir), efavirenz (Sustiva, Stocrin) and tenofovir (Viread), but I'm worried about the side effects. What's your advice?


    Should I Trust My HIV Doctor?
    In October 2004, I became ill with an extremely high fever and was hospitalized. I was first diagnosed with viral meningitis, and then they tested me for HIV. Later on I learned that I almost died and that my viral count was 750,000. I live in New York City and have an excellent HIV physician. He immediately started me on atazanavir (Reyataz), ritonavir (Norvir) and Trizivir (AZT/3TC/abacavir), but the Trizivir made me anemic, so he switched it to Epzicom (abacavir/3TC, Kivexa). My CD4 count is now 917 and my viral load is undetectable! I have little to no side effects from the meds, so all in all I feel extremely lucky. However, I wonder if I should seek a second opinion about my regimen. Everything I know about my HIV, labs, and meds is through this one doctor. I have no reason to doubt him, but of course I worry about everything now. I want to make sure I'm taking the right medications and doing the right things.

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      DRUG RESISTANCE

    Is Risk of Future Resistance Enough to Avoid Taking an NNRTI?
    I'm doing well on a HAART regimen of 3TC (lamivudine, Epivir), AZT (zidovudine, Retrovir) and efavirenz (Sustiva, Stocrin), but am worried about the potential risks of taking a non-nucleoside reverse transcriptase inhibitor (NNRTI) like efavirenz. A friend of mine was taking an NNRTI when he had a hepatitis A outbreak and had to stop treatment; the stoppage made him resistant to all NNRTIs! Do you think I should switch to tenofovir (Viread) + Trizivir (AZT/3TC/abacavir) to avoid any "accident" that could make me resistant to NNRTIs as well?


    Cutting Efavirenz Pills: Less Insomnia, More Resistance?
    To alleviate the insomnia my efavirenz (Sustiva, Stocrin) was causing, I began cutting my 600 mg tablets in two unequal pieces; I'd take two-thirds of the pill at night and the other third in the morning. This helped a lot, but when I told my physician's assistant that I had been cutting my pills, she said that I'd probably caused my HIV to become resistant to efavirenz. I thought I was being safe because efavirenz takes so long to clear out of a person's system, but should I be worried?

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      HAART SIDE EFFECTS

    Alleviating Ritonavir's Nasty Aftertaste
    I started feeling this terrible taste in my mouth about three weeks after starting a regimen of atazanavir (Reyataz), Combivir (AZT/3TC) and ritonavir (Norvir). Is there any way to lessen this vile taste, or am I stuck with it for life?


    Liposuction for Buffalo Hump and Breast Enlargement
    I'm a 36-year-old, HIV-positive man who's full of life, but my lipodystrophy is making me ashamed to leave my house! I'm taking 3TC (lamivudine, Epivir), abacavir (Ziagen) and nevirapine (Viramune), and have developed buffalo hump and breast enlargement. I feel embarrassed at work, where I'm constantly around reputable doctors, nurses and pharmacists. I live a normal life, but lately I've just wanted to stay home because I'm afraid people will make fun of my breasts and the hump on my back. Would liposuction be a safe option for me?


    Finding Relief for Stomach Problems on Kaletra
    I've been taking Kaletra (lopinavir/ritonavir) capsules for 9 months now, and the gastrointestinal side effects -- cramping, bloating, constant diarrhea -- aren't getting better. Could switching to once-daily dosing or the liquid formula help, or do I need to change meds?

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     HIV-RELATED HEALTH PROBLEMS

    Bio-Alcamid vs. Sculptra for Facial Wasting
    Which is the best product to use for facial wasting: hydrophilic polyalkylamide gel (Bio-Alcamid) or poly-L-lactic acid (Sculptra, New-Fill)? As I understand it, Bio-Alcamid has been used for facial wasting in Europe and Mexico for about six years with limited side effects. It basically fills the sunken area with a water-based silicon suspension that, after some time, the face forms a layer around. Sculptra actually thickens the skin from 2 mm to about 10 to 12 mm, but has its own possible side effects.


    Severe Constipation on Antidepressants and HAART
    I'm taking several different antidepressants in addition to my HIV meds. Even though I take Ex-Lax (a laxative) every other day, I have only one bowel movement every four days. When I do manage to go, it's extremely painful, and I have an anal fissure that sometimes opens and bleeds. How can I correct this?


    Solutions for Mild Anemia
    I'm required to take an annual physical for my job; it includes blood work. I asked my HIV doctor if anything in my blood work would give my status away and he said no, but I'm slightly anemic. Can I take a supplement or change my diet to rectify this? Epoetin alfa (Procrit) doesn't seem appropriate unless the anemia becomes more severe. What about switching off of the Combivir (AZT/3TC) in my regimen, since it's probably the AZT causing my anemia?


    Mind Your Interactions: ddI + Tenofovir
    Although my HAART regimen -- 3TC (lamivudine, Epivir), once-a-day ddI (didanosine, Videx EC), efavirenz (Sustiva, Stocrin) and tenofovir (Viread) -- was keeping my viral load undetectable, I had serious fatigue, dry mouth and a slowly declining CD4 count. My doctor decided to take me off the ddI, citing an interaction between it and the tenofovir. Within two weeks, my energy increased dramatically and my CD4 began to rise. I just wanted to throw my story out there; it seems like a remarkable return to normal energy levels after such a simple change!

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     HEPATITIS C & HIV

    Is Lipitor Safe for People with Hepatitis C?
    My husband is on treatment for HIV and hepatitis C. His viral load for both viruses is undetectable, but he's developed severe heart problems. His doctor has prescribed Lipitor to lower his cholesterol. Should we trust the doctor? I've heard that people with liver problems shouldn't take Lipitor, and my husband has hepatitis.


    Concerns About Interferon Therapy
    I was just diagnosed with hepatitis C, and am afraid of taking interferon treatment. My doctor says the treatment will affect my CD4 count (which is currently 540) and my HIV viral load (which is 119,000). Should I start taking interferon? I haven't decided yet whether to have a liver biopsy done, and know little about how far along my liver disease is.
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      WOMEN, CHILDREN & HIV

    Can HIV Cause an Unborn Baby's Death?
    I was diagnosed with HIV five months into my pregnancy. Two months later, my baby was born prematurely; she died the next day. Could HIV have been the cause of her death?

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      STRANGE BUT TRUE

    How Much Masturbation Is Too Much?
    Can masturbation cause fatigue, or make me less likely to conceive a baby? How much would you suggest I masturbate every day?


    Rub a Dub Dub, Two Men in a Tub
    What's my risk of contracting HIV by taking a bath with an HIV-positive person?
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    Art From HIV-Positive Artists
    Charles Drees, Thoughts on Eastern Pines, 2001: Image from the March 2005 Visual AIDS Web Gallery
    "Thoughts on Eastern Pines," 2001; Charles Drees
    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.