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October 16, 2006
In This Hot Topics:
  • First-Line HIV Treatment
  • HIV Drug Resistance
  • Complications of HIV & HIV Meds
  • Living With HIV
  • Mixed-Status Relationships
  • Hepatitis
  • HIV Transmission
  • Strange but True
  •  FIRST-LINE HIV TREATMENT

    CD4 Cell Death and Starting HIV Treatment Early
    My lab numbers are good enough that I technically don't need to start HIV treatment yet. However, I don't know if I should allow HIV to keep killing my CD4 cells during the years in which I'm not taking HIV meds. What do you think -- would starting treatment early have a better long-term impact on my immune system?


    How Long Does It Take to Get an Undetectable Viral Load?
    I started taking efavirenz (Sustiva, Stocrin) + Truvada (tenofovir/FTC) almost immediately after being diagnosed in April 2006. Then, in July, I switched to Atripla (efavirenz/tenofovir/FTC). My viral load has decreased, but it's been three months now since I started Atripla and I'm worried that my viral load is still detectable. How long should it take to achieve an undetectable viral load?


    Good Numbers, Bad Illnesses: Is My First-Line Regimen Working?
    I was diagnosed in March 2006 and started taking Kaletra (lopinavir/ritonavir) + Truvada (tenofovir/FTC) immediately. Since then, my CD4 count has risen from 26 to 167 and my viral load has decreased from 947,000 to 600. However, I've also developed Mycobacterium avium complex (MAC), severe joint pain, fatigue and substantial weight loss. Given this mix of good and bad news, are my meds working or not?


    I Started HIV Treatment During Acute Infection. Do I Have to Stay on Meds?
    My doctor put me on meds while I was in the "acute" phase of infection (my viral load was 600,000). It's been a year, and now my viral load is undetectable and my CD4 count is 584. Do I have to stay on meds even if I don't like them?
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     HIV DRUG RESISTANCE

    If I'm Already Multidrug Resistant, How Long Can This Regimen Last?
    I recently found out that I have become resistant to most HIV meds. My doctor put me on a new regimen, but he said I had no other options and that things didn't look good. Still, my CD4 count is 673 on the new regimen and my viral load is undetectable. How long can I expect this to continue? Can I truly expect to live another 10 years if I have no other options?


    Late Doses, Viagra and HIV Drug Resistance
    If I'm slightly late with my HIV med doses every now and then, can I develop HIV drug resistance? And what about Viagra -- can it interfere with any of my meds and bring about resistance?


    What Should I Do if My Meds Keep Failing?
    I've taken most of the antiretrovirals that are currently available and have participated in clinical trials of TMC114 (darunavir, Prezista) and TMC125 (etravirine). However, my viral load has never reached undetectable. Currently, my CD4 count is 31 and my viral load is 84,000. I also have recurring oral and vaginal thrush. My doctor and I are confused by how my virus seems to keep defeating every treatment we've tried. What can I do?
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     COMPLICATIONS OF HIV & HIV MEDS

    Are My Meds Making My Eyes Yellow?
    I've been on atazanavir (Reyataz) + ritonavir (Norvir) + Truvada (tenofovir/FTC) for a year and a half, and the whites of my eyes have turned yellow. What should I do about this? I'm otherwise happy with my regimen; I'm just sick of people asking me if I have hepatitis.


    Will an HIV Med Switch Relieve My Side Effects or Make Things Worse?
    I've been experiencing fatigue and heartburn while on atazanavir (Reyataz) + Epzicom (abacavir/3TC, Kivexa) + ritonavir (Norvir). However, my viral load is low and my CD4 count has gone up from 250 to 377. Today my doctor switched me from atazanavir to fosamprenavir (908, Lexiva, Telzir). Will that help get rid of the fatigue and heartburn? Will switching meds put me at higher risk for lipodystrophy?


    Steven-Johnson's Syndrome and HIV Treatment
    Is it true that someone who has had Steven-Johnson's Syndrome should not take HIV meds?
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     LIVING WITH HIV

    HIV Meds on Planes: Carry Them On, Or Leave Them in My Checked Bags?
    With the recent increase in airport security, I'm concerned about taking my meds in my carry-on luggage. However, if I place them in my checked bags, there is a chance that my bags could be lost or delayed. If I were to go without meds for a period of time because my luggage didn't arrive at my destination, would I be putting myself at significant risk for developing resistance?
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     MIXED-STATUS RELATIONSHIPS

    My Newly HIV-Positive Girlfriend Is Pushing Me Away
    My girlfriend just tested positive. When she called to tell me, she broke up with me. I know that she's freaked out and worried about infecting me, but I'm not willing to give up on our relationship. What can I do to help her deal with her diagnosis?
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     HEPATITIS

    Why Did My CD4 Count Drop When I Started Hep C Treatment?
    I have HIV and hepatitis C. After starting hepatitis C treatment, my CD4 count dropped below 200, but my CD4 percentage stayed above 30%, which is very good. Meanwhile, both my HIV and hepatitis C viral loads are undetectable. What's going on here? How can my CD4 count be so low when all my other numbers are so good?


    Cocaine Snorting and Hepatitis C Transmission
    If you share straws with somebody when snorting cocaine, can you put yourself at risk for getting hepatitis C?
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     HIV TRANSMISSION

    I've Heard the Strangest Rumors ...
    Can you tell me if any of the following are true? 1) HIV started when a human had sex with a monkey. 2) An HIV-positive guy can infect a dozen other guys if they all share a steroid needle at the same time. 3) In Africa, many people believe that having sex with a virgin cures them of HIV.


    I Know I Got HIV Through Oral Sex -- I Don't Need a Test to Tell Me!
    I'm 100 percent certain that I got HIV when a sex worker gave me oral sex. I haven't been tested yet, but my symptoms are so obviously HIV-related that I'm not even sure I should bother with a test.


    A Bathhouse Encounter and Post-Exposure Prophylaxis
    I thought a guy was giving me a blow job, but it turned out he had inserted me into his rear end (without protection). This happened at a bathhouse a couple of weeks ago, and though I pulled out before ejaculating, I went to the emergency room on the advice of my doctor. The emergency room doc felt there wasn't even any need for me to be there, but he prescribed a post-exposure prophylaxis regimen of Combivir (AZT/3TC) + nelfinavir (Viracept), which I'm now being told I have to continue for three months. Does three months of post-exposure prophylaxis sound right to you? Was my experience a high enough risk that I need to take these meds at all?
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      STRANGE BUT TRUE

    I Have Unspreadable HIV
    I've had sex thousands of times with three different partners, and even though we don't use protection, they've never become infected. What do you call my kind of HIV infection?
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    Live Chat @ The Body!
    Read the Full Transcript of Our Online Chat on Fatigue and Anemia With Dr. Bob!

    Dr. Bob Frascino
    Dr. Bob Frascino, one of The Body's most popular experts, recently answered a host of fatigue-related questions from HIVers at our latest online chat. Using his trademark wit and humor, Dr. Bob offered his thoughts on fatigue's many possible causes and treatments. Read this chat transcript for the full story!

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the October 2006 Visual AIDS Web Gallery
    "Tear Drop," 1994; Hunter Reynolds (collaboration with Maxine Henryson)
    Visit the October 2006 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery is entitled "Stardust: A Two-Part Show"; it's curated by Leah Oates, an artist and independent curator living in New York.