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May 22, 2006
In This Hot Topics:
  • HIV & Family Problems
  • Living With HIV
  • Understanding Your Labs
  • Switching HIV Meds
  • HIV Drug Resistance & Rescue Therapy
  • HIV-Related Complications
  • Health Coverage & HIV
  • Strange but True
  •  HIV & FAMILY PROBLEMS

    In our last "Hot Topics" newsletter, we highlighted a post from a "worried father" who asked whether he should kick his newly diagnosed son, Jake, out of the house in order to "protect" himself, his wife and his other children. Since Dr. Bob's Frascino's emphatic response (click here to read it), other people -- including the HIV-positive son -- have written their own posts.


    Son of "Worried Father" Defends His Dad
    I know my father came across badly in his post, but honestly, he's not a bad guy: He's just angry and worried because I've gotten myself infected and didn't tell him. My coming out was tough on him, and this is tougher. It's not that he wants to throw me out, it's that it might be better for everyone if I go. He just wants a happy home for his family, and I'm making that damn near impossible. That doesn't make me right, or him wrong. I'm going to move out for a bit, let him deal with it first. I may have screwed myself up, but I'm not gonna cause collateral damage.


    You're Not Alone, Another HIVer Says
    I had virtually the exact same experience with my parents as Jake is experiencing right now. Hang in there, Jake; whatever you do is going to be tough, but things will get better. They really will. I agree with all of Dr. Frascino's advice in principle, but it's easy to stick to principle when nothing's at stake. Reality, however, is just so different from how I wish it were -- and here's why.
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     LIVING WITH HIV

    What's the Long-Term Prognosis for a Young, Newly Infected HIVer?
    I've been reading these forums for a while now, and I understand that you experts believe that a normal life span is very possible for those who have access to current, up-to-date treatment. I know that this is probably possible for someone who is in their 40s or 50s, but are you equally optimistic about someone who is newly infected and is in their teens, 20s or 30s? I keep reading about people who have to switch medications due to resistance issues and go on "salvage" regimens. Do you think currently evolving drug classes will extend the lifespan of a young, HIV-positive person into their 80s or 90s?


    Can I Be an HIV-Positive Marathon Runner?
    Does running marathons pose any health risk for a person with HIV? I have a CD4 count of 400, a viral load of 3,500 and am not on treatment.


    Where Does My HIV Hide?
    Why am I still HIV positive if my viral load is undetectable? Where else in my body could HIV be hiding, and are there any treatments being developed to eliminate HIV from these places?
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     UNDERSTANDING YOUR LABS

    Confusing Lab Numbers After Starting Treatment
    I was diagnosed with HIV in November 2005, after being hospitalized with a fever, low platelet count and enlarged lymph notes. My CD4 count was 434, but my viral load was above 100,000, so my doctor started me on treatment with 3TC (lamivudine, Epivir) + efavirenz (Sustiva, Stocrin) + tenofovir (Viread). In February my labs showed that my viral load was down to 20,000, but my CD4 count had dropped to 261. What's going on? Does this mean my new regimen isn't working? Could my November or February CD4 count have been wrong?


    Does It Matter How Sensitive My Viral Load Test Is?
    I recently had to switch HIV doctors. My old doctor used a viral load test that could detect HIV at levels as low as 50 copies/mL, but my new doctor uses a test that can't detect less than 400 copies/mL. What if my next viral load test is between 50 and 400, but I don't know it? Should I worry that the less-sensitive viral load test might miss a sign that my treatment has stopped working?
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     SWITCHING HIV MEDS

    Should I Simplify From Trizivir to Combivir?
    I've been on efavirenz (Sustiva, Stocrin) + Trizivir (AZT/3TC/abacavir) for three years, and am doing well: my viral load is undetectable and my CD4 count is up to 625. However, I recently read about a study that said efavirenz + Trizivir is no more effective than efavirenz + Combivir (AZT/3TC), which has one less drug in it. While I'm mostly thinking, "If it ain't broke, don't fix it," I wonder if a switch from Trizivir to Combivir could keep me undetectable while reducing my risk for long-term side effects. What do you think?


    Should I Switch to Stop Side Effects on 3TC + d4T + Kaletra Capsule?
    I've been taking 3TC (lamivudine, Epivir) + d4T (stavudine, Zerit) + the old capsule form of Kaletra (lopinavir/ritonavir) for the past year. The regimen has done a good job suppressing my HIV, but the side effects have been hard to deal with: stomach problems, low energy, trouble sleeping. How much will switching to the new tablet form of Kaletra help? Should I consider switching other drugs in my regimen?
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     HIV DRUG RESISTANCE & RESCUE THERAPY

    My Clinic Won't Give Me a Resistance Test
    I'm about to start HIV meds, but the nonprofit clinic I go to refused to give me a resistance test -- even after I offered to pay for it myself! What should I do?


    Resistant to Everything and Frustrated
    Since I was diagnosed with HIV 13 years ago, I've been on many different treatment regimens, but have never had an undetectable viral load. I'm now resistant to most of the meds my doctor has prescribed for me, and have no idea why. What's going on? What options do I have?


    Questions About Fuzeon: Where to Inject, Refrigeration and Mixing
    My partner has lost most of the fat on his thighs, so he now injects T-20 (enfuvirtide, Fuzeon) solely into his stomach. However, his site reactions are getting progressively worse; are there any other places on his body he can inject? Also, just how important is it to refrigerate doses, and is it OK to take doses that have "globs" left in them after mixing?


    Anxiety Attacks While Taking T-20
    Six days after I started taking T-20 (enfuvirtide, Fuzeon) as part of a new treatment regimen, I had a severe anxiety attack. My clinic gave me meds to calm me down, but I've been avoiding T-20 ever since. Are anxiety attacks common for people taking T-20? What can I do to avoid them?
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     HIV-RELATED COMPLICATIONS

    Can I Drink Alcohol if I Have HIV and Hepatitis C?
    How much, if any, alcohol is safe to drink for people with HIV/hepatitis C coinfection? I'm on HIV treatment, and my last CD4 count was 425 with an undetectable viral load. I had a liver biopsy five months ago that showed minimal inflammation of the liver, so my doctor feels no need to treat my hepatitis C. Should I drink at all at this point?


    Liposuction for Buffalo Hump
    I've decided to have liposuction to get rid of my buffalo hump. Are there any downsides to this operation? Will it cause any pain or bruising?


    High Insulin Levels, Just Tested HIV Positive
    I was recently infected with HIV and I'm hyperinsulimic. How could my HIV status affect my health?


    Diagnosed With AIDS and Kaposi's Sarcoma
    I tested positive for HIV in March after being diagnosed with Kaposi's sarcoma (KS). I was immediately put on HIV treatment, but my doctor said my CD4 count, at 199, was too low for chemotherapy. Now my CD4 count is up to 318 and my doctor is very pleased, but the KS is progressing very quickly and I'm freaking out. Is it safe for me to start chemo now? What are my chances for survival?
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     HEALTH COVERAGE & HIV

    Long-Term Care Insurance for HIVers?
    I know it's hard to get life insurance if you're HIV positive, but what about long-term care insurance?

    My Long-Term Disability Holder Is Asking for an HIV Test
    The company that underwrites my long-term disability plan sent me a letter telling me I have to get a physical exam and be tested for HIV. If it comes up positive, will they deny me coverage -- and will they report my test results to my employer or other insurance companies?
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      STRANGE BUT TRUE

    Good Night, Sleep Tight, Don't Let the HIV Bugs Bite
    If I share a bed with an HIV-positive person, can a bedbug transmit the virus from him to me?


    Could a Coin From a Change Machine Have Given Me HIV?
    After leaving a car park, I paid the parking fee to a machine and recevied some change. I noticed later that one of the coins had a red line on it. I tried scraping it off with my nail, but then I thought, what if this is dried blood, and I just got some of it under my nail? Is that a mucous membrane under there? Could I have put myself at risk for HIV?
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    Visual AIDS
    Art From HIV-Positive Artists

    Image from the May 2006 Visual AIDS Web Gallery
    "Self-Portrait," 2001; Phillip Calkins
    Visit the May 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The May gallery is entitled "The 'Me' You See"; it's curated by Reed Massengill, a widely published writer and photographer who specializes in male nudes.