•  HIV TREATMENT

Efavirenz + Truvada as First-Line Treatment
Since my diagnosis in late 1999, my CD4 count has steadily dropped -- from 618 to 218 -- while my viral load has stayed low, hovering between 2,000 and 10,000. My docs are waiting for my next CD4 count before we decide whether to start treatment, but they've recommended efavirenz (Sustiva, Stocrin) and Truvada (tenofovir/FTC) as a first regimen, if the need arises. What's your take on this regimen, and on my situation in general?


Should I Restart an Old, Unusual Regimen?
I spent 8 and a half years on a HAART regimen that worked well, even though researchers later found that it generally doesn't work in HIV-positive people. I had to stop taking the regimen recently, after I lost my job and health insurance, and was put on a waiting list for my state's AIDS Drug Assistance Program. When I stopped, my CD4 count was in the high 800s and my viral load was undetectable. Six months later, my CD4 count has slipped to between 675 and 750, and my viral load has climbed to 4,000. However, I found a new job and am once again covered by health insurance. Should I restart my old treatment?


Which Is Better: A Massive HIV Clinic or a Small Private Practice?
I was diagnosed last October and referred to a large HIV clinic at a reputable university for my care. I felt physically horrible -- anxiety/panic attacks, blurred vision, swollen glands -- but my doctor at the clinic didn't seem concerned. My symptoms got worse, and I had to harass the clinic to get more lab work done; the tests found that although my CD4 count was holding around 400, my viral load had jumped from 26,000 to 36,000 in a month. Still, the clinic doctor insisted my symptoms were related to depression and sent me on my way. In December, I went to a much smaller, private practice, where the doctor gave much more personal attention -- and where new labs showed my viral load had jumped to 130,000. I was immediately put on treatment. I'm glad I got that second opinion, but now I'm wondering: Should I stay at this small, private office? Or should I go back to the clinic, which is much more well-known and has a much more comprehensive approach to m y overall health care?


Effects of Crack on HIV and HAART
Before I was diagnosed with HIV, I never took drugs. But when I was diagnosed last summer, I started smoking crack once a week -- I figured I might as well, since I've ruined my life anyway. But now, I'm about to start HIV meds, and I'm worried. Do you think the crack has made my HIV disease worse, or that smoking it will interfere with my treatment?

• LIVING WITH HIV

Prognosis for Someone Who's Refusing HIV Treatment
My partner stopped taking his meds 14 months ago, and now he has a CD4 count of 50 and a viral load over 80,000. He's refusing any kind of HIV treatment or meds to reduce his risk of other infections. What's his prognosis? Is there anything I can do?

• HIV-RELATED HEALTH PROBLEMS

Are There Interactions Between Cholesterol Drugs and NNRTIs?
Are there any interactions between statins -- cholesterol-lowering drugs like atorvastatin (Lipitor) -- and non-nucleoside reverse transcriptase inhibitors (NNRTIs)?


Diagnosing and Treating Mild Anemia (and Finding a Good HIV Doctor)
Should mild anemia be treated -- and if so, with what? I've read conflicting advice in literature, and my doctors have been no help at all. They didn't even tell me I had anemia, even though I've had two extended bouts of fatigue in the past two years. [Editor's Note: This is an exceedingly long, though interesting, forum post.]

•  HIV/HEPATITIS TRANSMISSION

Hepatitis C Sexual Transmission Risks
How common is sexual transmission of hepatitis C between men? Should an HIV-positive man who has unprotected anal sex with other HIV-positive men be worried about the risk of coinfection with hepatitis C?


Anal Fisting and Hepatitis C
If I'm the insertive partner in anal fisting with a hepatitis C-positive guy, and I don't wear gloves, what are the risks of me contracting hepatitis C as well?


Canine HIV Transmission
Let's say a dog scratches or bites an HIV-positive person and then scratches or bites you. Can the dog transmit HIV?

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