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Hot Topics at The Body's "Ask the Experts" Forums
If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html
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HIV TREATMENT
Choice of Two Combos: Which One Is Best?
I've been HIV positive for about two years and my last CD4 count was 345. I've been offered to start treatment with either Videx (didanosine, ddI), Epivir (lamivudine, 3TC) and Sustiva (efavirenz, Stocrin); or Combivir (AZT/3TC) and Sustiva. I'd like to start with the first combo since it is a once-a-day regimen, but there are many guides that recommend Combivir and Sustiva. Can the first combo be as good as the second one, regarding possible side effects as well as being able to fully suppress HIV?
I'm 100% Adherent But My Regimen Is Failing
This is more of a hypothetical question, but one I'm sure is a concern to many, including myself. Why do HIV regimens fail in adherent patients who have no HIV resistance mutations detected during viremia?
HIV IN THE WORKPLACE
Do I Have to Tell Nursing Schools and Employers That I'm Positive?
I have been HIV positive since the 1980s and I'm interested in pursuing a nursing career. One of the programs I'm applying to requires a drug test and health screening in which I will have to disclose my medications. Isn't this the same as telling my employer my HIV status? What are my legal obligations in terms of disclosure? I am comfortable that I can provide quality, safe care, but I don't want to be naive either.
Short Term Disability: How Should I Proceed?
I have been at my job for more than four years. I have lots of accrued leave and vacation time. I was diagnosed HIV positive about three years ago. I haven't needed to use much time in tending to my condition until recently. But I've been experiencing a bunch of side effects from my medications, including fatigue, diarrhea, cloudy thinking, etc. I was considering applying for short-term disability to get some rest and explore options with my doctor for resolving some of these side effects. Am I qualified to apply?
HIV DRUG RESISTANCE
Anticipating Future HIV Drug Resistance
Although my CD4 count has always been between 720 and 780 and my viral load has been stable at 25,000, I am thinking of starting HIV treatment since I want to decrease the risk of HIV transmission for my long-term HIV-negative partner. I have to make a decision regarding which regimen to choose. I was interested in a regimen containing Norvir (ritonavir)-boosted darunavir (Prezista). Now I am second-guessing this because of something I read about resistance by the makers of darunavir. If I develop resistance to darunavir, what protease inhibitor would remain? I worry about limiting my future choices and want to plan ahead.
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Over 50 and Just Tested Positive
(A recent post from the "I Just Tested Positive" board)
Hi, newly infected and over 50. I found out in May and started meds five weeks ago. Had to stop Atripla after three weeks -- a nightmare. Now on Epzicom and Viramune for two weeks and will start twice-a-day dosing of Viramune tonight.
Question: I have long bouts of fatigue, with spurts of some energy and no appetite to speak of. I'm hoping that this will pass. How long does it take to get used to meds -- I know it varies. But does it take many people three weeks, four weeks, months? I thought I would just bear it out with Atripla, but got really ill. I'm hoping this new regimen will work. Any info would be helpful.
-- calguy2009
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YOU AND YOUR LABS
Why Do CD4 Counts Go Up and Down?
I was diagnosed with HIV in June 2008 with CD4 count of 690, a CD4 percentage of 36 percent and a viral load of 18,000. Over the past year, my viral load has dropped but my CD4 count has fluctuated. My first doctor explained that CD4 levels rise and fall all the time. Do you know about this, and can you explain it further? Can CD4 percentage rise and fall the way CD4 count does, or will that number just continue to drop over time?
HIV Positive and Thinking of Moving to United Arab Emirates for Work
I am thinking about taking employment in the United Arab Emirates. As part of their government medical exam for residency they require an HIV test. If my viral load is undetectable, will I pass this exam?
My Viral Load Is Low but Blood Work Shows High Abnormal Proteins: Is This Normal?
I was diagnosed with HIV 10 years ago. My viral load is 5,300 and my CD4 count is 500. I have never been on treatment, but my body is constantly fatigued and in pain. I have various symptoms which I'm not sure are HIV-related -- my blood work and urine tests show high abnormal proteins and I also have severe neck pain and a skin rash on both arms. My MRI and bone scans are normal. Would you say I should start HIV treatment? If so, what is the best regimen, especially if I'm trying to get pregnant?
HIV BODY SHAPE CHANGES
Is Leptin Effective in Dealing With HIV-Associated Belly Fat?
I have been HIV positive for 24 years and I have really awful belly fat. I was thinking of using the hormone leptin and also wondering if herbal supplements would work. I am currently taking Truvada (tenofovir/FTC), Norvir (ritonavir) and Lexiva (fosamprenavir, Telzir), as well as a number of other medications.
COINFECTIONS COMPLICATIONS OF HIV/HIV MEDICATIONS
Could Truvada or Sustiva Be Making My Gastritis Worse?
I have been struggling with gastritis since even before I was diagnosed with HIV. It seems that either the Sustiva (efavirenz, Stocrin) or Truvada (tenofovir/FTC) I take is making it worse. What can I do? There is nothing as irritating as heartburn or a burning feeling after a meal.
Is Bad Breath a Side Effect of HIV Meds?
Is it common for someone on HIV antiviral medications to experience very bad breath? If so, how is it treated -- or can it be? My coworker's breath is so bad that it's hard to stand four feet away from this person without smelling his/her breath.
What Is the Implication of Having Had Hepatitis A in the Past?
If I had hepatitis A years ago, does that mean that I am a carrier of it and can pass it to present and future partners? If so, is there anything that could be done to protect my partners from getting it?
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How's This for a Recent Infection?
(A recent post from the "I Just Tested Positive" board)
I recently found out I was HIV positive and the entire ordeal has opened my eyes to so many things that I needed to make changes to in my life ... I didn't truly get the positive result back until last week; however, my story goes like this:
One day I had a fever of 105 and went to the emergency room, back in May ‘09. I was admitted to the hospital for the next month being tested for everything and all were coming back negative. The doctors told me that I was so recently infected with HIV when I arrived in the emergency room that they basically watched my viral load go from 25,000 to over 2 million over the next month. They could not diagnose me as having HIV until they received the positive western blot back. My last negative test was July 1st. Since the positive test was returned last week, I am now a candidate to receive meds and learn more about the particular strain of the virus that I contracted. … I didn't have to worry about telling my family because they were there with me in the hospital when the doctors explained: "We see the virus in his blood, but he's still testing negative; its just a matter of time before we get the positive results in, then we can begin to discuss treatment options." MY APPOINTMENT'S TOMORROW!
-- c1no1
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STRANGE BUT TRUE
If a Dog Bites Someone With HIV and Then Bites You...
I just got a puppy six months ago. He loves to teethe and sometimes he gets a little wild and teethes on my arm -- recently he was biting my arm for a good five minutes, and it left a few cuts. I'm worried because the day before he was teething on my friend who has AIDS. Am I at risk? Wouldn't this be the same as sharing needles?
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