•  ISSUES FOR TREATMENT-EXPERIENCED HIVERS

Can Old Resistance Hurt a New Regimen?
Can pre-existing NRTI resistance reduce the efficacy of a regimen containing Truvada (tenofovir/FTC)? I took NRTIs from 1991 to 1999 (much of that time was before HAART existed), but then took a treatment break until this year. I've been taking efavirenz (Sustiva, Stocrin) and Truvada for 75 days now, and though my viral load almost immediately dropped by more than 99%, my two-month checkup showed a slight rise. A resistance test back in 1998 found 3TC (lamivudine, Epivir) resistance. Could that be why my treatment response hasn't been even stronger?


Choosing Between Two Protease Inhibitors in Development
I'm resistant to most HIV meds. My doctor has recommended I switch to a regimen containing T-20 (enfuvirtide, Fuzeon) and one of two protease inhibitors in development: tipranavir or TMC-114. I could start tipranavir now, or I could wait and join a TMC-114 trial this summer. My CD4 count is 60 and my viral load is over 100,000. Should I go with the tipranavir, or wait for the TMC-114?


Should I Keep Waiting for a New Drug Class?
I was diagnosed with HIV in 1993, and since then have developed resistance to many different HIV meds; although I've gotten great medical care, if my doctors and I knew then what we know now, we never would have switched meds so often. Lately my health and numbers have been declining (CD4 count 60, viral load 180,000), and my doctor is anxious to start me on T-20 (enfuvirtide, Fuzeon) and tipranavir. But a specialist at a nearby university is recommending I wait a while longer, and then enroll in a clinical trial that will include a new class of drug -- an integrase inhibitor -- along with T-20 and tipranavir. Would it be worth it to wait?


Was It the Wrong Time for T-20?
My husband was diagnosed with AIDS and multiple opportunistic infections in October 2002, but got better thanks to a wonderful doctor and 98% adherence to his HAART regimens. He's been through a couple of regimens, though -- the first one was stopped due to side effects, and his viral load began creeping up while on the second. When his viral load reached 614 a couple of months ago, his physician added T-20 (enfuvirtide, Fuzeon). But lately, my husband has also become depressed and angry, and stopped adhering well to his new regimen. What should we do? Was adding the T-20 a good idea?

•  STARTING HIV TREATMENT

First-Line Therapy Choices
I'm likely going to have to start treatment soon, and was hoping to get your opinion on the "perfect" combination of meds. What's your take on Epzicom (abacavir/3TC, Kivexa) vs. Truvada (tenofovir/FTC)? Non-nucleoside reverse transcriptase inhibitors (NNRTIs) vs. protease inhibitors?

•  LIVING (AND DATING) WITH HIV

Disclosing to an HIV-Negative Partner in a Threesome
My partner of 19 years (who's negative) and I (positive) want to bring a third man into our relationship. Everything seems to be going well, but now we have to figure out how to tell him I have HIV. Can you suggest a way of breaking this news to our new partner?


Health Priorities for HIVers
What do you feel are the three most important health priorities for a person living with HIV?

•  MOTHER-TO-CHILD HIV TRANSMISSION

Breastfeeding Risk for Undetectable Moms
Can a mother transmit HIV to her baby through breastfeeding, even if the mother has an undetectable viral load?

Your Unused HIV Meds
Can Save Lives!