Count 575, VL 48,000: The Right Time to Start Meds?
I've just been diagnosed with HIV; my CD4 count is 575 and my viral
load (VL) is 48,000. My doc is recommending aggressive treatment with
Truvada (tenofovir/FTC) and efavirenz (Sustiva, Stocrin), but I'm
scared of the side effects I've read about that efavirenz can cause.
Should I consider holding off on meds?
Once a Day to Once Every Two Days?
Are any studies being done to test whether some HAART regimens can
be taken every other day? A friend of mine recently started
taking his atazanavir (Reyataz) + Truvada (tenofovir/FTC) regimen
every other day after discussing it with his doctor.
Two HAART Regimens Together
My doctor switched me from Combivir (AZT/3TC) + nelfinavir (Viracept)
to a new regimen of atazanavir (Reyataz) + ritonavir (Norvir) + Truvada
(tenofovir/FTC). Since I still have plenty of the Combivir and nelfinavir
pills left over, I've continued taking them as well so I can use them
up. Is this dangerous?
Risks Involving Boosted Protease Inhibitors
I'm taking atazanavir (Reyataz) + ritonavir (Norvir) + Truvada
(tenofovir/FTC), which is a boosted protease inhibitor-based regimen.
I'm doing well, but I'm concerned about possible interactions between
my HIV meds and other medications or supplements. For instance, I
recently took a generic, over-the-counter version of Sudafed, and
went through the roof -- I didn't sleep for three days! Given this
reaction, I'm concerned about some other things I'm considering taking:
Propecia (generic name: finasteride) for hair loss, as well as some
antacids, common vitamins and supplements. What do you think?
SENSE OF CD4 COUNTS
of Spleen Removal on CD4 Count
I'm a 50-year-old who was diagnosed with HIV 16 months ago. Although
I've been told I may be a long-term nonprogressor, my CD4 count dropped
from 1,700 to 1,100 within a year, leading me to suspect my immune
system may not be as strong as previously thought. I'm particularly
worried because I had my spleen removed after a road accident some
40 years ago, and I've read that asplenic patients such as myself
can have misleadingly high CD4 counts. My doctors, however, seem to
be unaware of this literature, and have scheduled my next appointment
for three months from now. I'm concerned that within this time I may
lose the advantage of an early diagnosis and strong immune system.
Do you think I have cause for concern? Should I consider asking to
be put on HAART?
Won't My CD4 Count Top 500?
When I tested HIV positive last September, my viral load was over
100,000 and my CD4 count was 305 (31%). I started HIV treatment right
away, had no side effects, and within three months my viral load was
undetectable and my CD4 count was up to 500 (41%). I'm thrilled, but
my doctor said that my CD4 count will probably not go much higher.
If, as he notes, little damage has been done to my immune system,
why won't my CD4 count go any higher?
a Person Use COBRA After Quitting a Job?
I'm an unhappy employee living with HIV in Georgia. I'd like
to pursue other work opportunities, but I get health insurance through
my employer's group plan. In my line of work, the majority of available
jobs are contracting positions that do not provide health insurance.
If I resign from my present job, will I still be eligible for COBRA?
Are there any insurance providers that would insure my pre-existing
Jobs and Health Plans: Coverage and Privacy Concerns
I'm planning to start a new job (and to switch health insurance
plans) in Massachusetts, but because I'm on HIV treatment, I have
several concerns about health coverage. First, my new job starts
three days after my old job ends, but I don't know when my new health
insurance will begin. If it doesn't begin immediately, do I need
to sign up, or am I eligible for COBRA? Second, my new employer
will require a physical. Could this include an HIV test -- and if
so, could I be refused coverage? Third, my new employer may allow
insurance for domestic partners, but my partner is HIV positive
as well. Will he be tested for HIV as well?
WITH HIV: TRAVEL, PRIVACY & DRUG TESTING
Meds and HAART
I have plans to travel to Africa, and was advised to take anti-malaria
medications. I take Combivir (AZT/3TC) and efavirenz (Sustiva, Stocrin);
are there any problems that you're aware of with taking these meds
along with a preventive malaria medication?
Summer Camp, HIV and Privacy
When we adopted our daughter shortly after her birth, we knew
she was HIV positive. She is now 13 and has had absolutely no health
problems. She has been on HAART since 1996 with a consistently undetectable
viral load. Her CD4 count has always been within the normal range
for HIV-negative children but has naturally decreased since her
infancy: It is now 925 (42%). She is on Truvada (tenofovir/FTC)
and efavirenz (Sustiva, Stocrin). She desperately wants to go to
a six-week summer camp with her girlfriends, but we are in a quandary:
The camp requires that all medication be dispensed through the camp
nurse. Obviously, none of her friends know about the HIV. We live
in a very small suburban community and public knowledge of her condition
would be devastating (we commute into the city for her HIV/pediatric
care). As I see it, we can either 1) stop therapy for six weeks
and disclose nothing to anyone, or 2) disclose to the camp and pray
that there are no leaks and that the camp nurse doesn't freak out.
Both options worry me greatly. What are your thoughts?
Drug Tests From HIV-Related Meds?
A recent drug test came back positive for cocaine and marijuana,
but I have not done either of these drugs in about 10 years. Could
any of my prescriptions have caused false-positive test results?
I am on: 3TC (lamivudine, Epivir), Kaletra (lopinavir/ritonavir),
tenofovir (Viread), a multivitamin and several meds to prevent or
treat opportunistic infections. Also, I have had several CAT scans,
as well as radiation treatment for Kaposi's sarcoma. Would any of
this affect a drug screening?
Bob's Personal Experience With Sculptra
Dear Dr. Bob: I postponed a scheduled procedure last week to
inject poly-L-lactic acid (Sculptra, New-Fill) into my cheeks to
treat facial wasting. I did this because I will be my cosmetic surgeon's first Sculptra
patient and am hesitant about being his "first," even
though he assured me that he would not overfill. You are the only
person I know of who has had this procedure done; are you 100% happy
with your results, and would you recommend it?
Some AIDS-Related Dementia Irreversible?
When I started HAART in November 1998 my CD4 count was 46 and
my viral load was 466,000. I also had dementia, which had advanced
to the stage where I was experiencing significant cognitive and
motor-function impairment, including stumbling, dropping things
and slurring of speech. On the plus side, since 1999, my viral load
has been undetectable and my CD4 count has risen to 475. However,
I continue to experience cognitive problems: poor memory, inability
to concentrate, irritability, anxiety, depression, etc. I know there
are many causes for these symptoms, but could the dementia have
caused damage to my brain and nervous system that HAART cannot reverse?
of Recurring Staph Infections
I've had recurring staphylococcal infections -- four in the
past year, each of them resistant to methicillin. Each time I have
taken large quantities of Bactrim DS (generic name: sulfamethoxazole
and trimethoprim) after a culture indicated susceptibility to the
drug. Each abscess was also lanced and drained, and I've taken several
other steps to treat these infections and prevent new ones. I'm
currently completing treatment for the latest infection: I initially
did 10 days of Bactrim DS once a day, then upped it to six a day
for another eight days. To "eradicate" the infection,
my doctor has prescribed an even more intensive course of treatment.
Are we taking the right strategy to wipe out these recurring staph
Am I Getting Pancreatitis?
I've had two incidents of pancreatitis in the past two years,
and was wondering if you knew why it might be happening. I've been
HIV positive for 20 years and am in relatively good health, with
a CD4 count near 1,000 and an undetectable viral load. I've been
on two different HAART regimens and several other medications. My
triglycerides have been high for some time but not "over the
top," and my cholesterol levels are within norms. I watch my
diet very closely, get a moderate amount of exercise and weight
training, and never miss a med dose. Why do I keep getting pancreatitis?
Undetectable, HIV-Positive Woman Wants to Have Unprotected Sex With Hubbie
I am an HIV-positive lady married to a loving and kind HIV-negative
man. My last CD4 count as of April 2005 was 1,080 and my viral load
was undetectable. Do you think with my viral load it is OK to have
sex without a condom?
Out Your Partner Has HIV -- Without Him Telling You
I just heard from someone that my partner is HIV positive! I
was shocked! Before we ever hooked up I asked "the question"
and he said he was fine! I am pretty sure he was lying back then
because I just did some investigating, and found bottles of HIV
medications. My partner and his friends never talk about his status
(obviously); it seems to be a non-issue in his life. We have never
had unprotected sex. I feel upset that he hasn't told me, but am
not sure how to bring it up. I don't want him to feel bad. I'm having
a really hard time with this; I feel a lot of guilt for not being
HIV positive myself. How can I broach the subject without upsetting
Injuries and Post-Exposure Prophylaxis
I had an accidental needle stick to a vein, but decided to stop
post-exposure prophylaxis treatment due to side effects, and because
Im not sure how at risk I really am. For instance, I don't
know if the needle had previously been in contact with an HIV-positive
person. I'm a housekeeper and was stuck through a trash bag. What
are my risks of getting HIV from this needle stick? Do you think
I made the right decision about stopping the HIV treatment? If I
have already been infected, would it really help?
Strap-Ons and HIV Risk
I'm a guy with a thing for girls using strap-ons and butt plugs
on me. Recently, I went to a sex worker who used a strap-on (with
a condom), but I started to panic after I realized how many other
guys she may have used it on. Do you think I'm at risk for HIV?
|Meet the Winners of TheBody.com's 2005 HIV Leadership Awards!
Dr. Kristen Ries, one of 10 outstanding HIV physicians who have
won a 2005 HIV Leadership Award from TheBody.com. Dr. Ries' name
is synonymous with HIV care in Utah: She directly or indirectly
cares for nine out of every 10 HIV-positive patients in the state,
be they in Salt Lake City (population 182,000) or Spring Lake (population
469). She has been treating HIV-positive people throughout the state
since the earliest years of the epidemic.
Want to meet all 73 winners of TheBody.com's 2005 HIV Leadership
|Art From HIV-Positive Artists
c. 1985-1988; Juan Rivera
| Visit the new June
2005 Visual AIDS Web Gallery to view this month's collection of
art by HIV-positive artists!