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November 27, 2006

HIV Treatment

Living With HIV

Complications of HIV HIV Meds

HIV Transmission

Hepatitis C

Strange but True

• LIVING WITH HIV

Am I Legally Required to Disclose My HIV Status to My Partner?
I have heard of HIV-positive people getting sentenced to life in prison for not telling their partners about their HIV status before having unprotected sex. But if I decide to have protected sex or oral sex with my partner without telling her my status, can I still go to prison?

How Long Can a Child Born With HIV Expect to Live?
Can a child born with HIV hope for a normal lifespan? What treatment is recommended? Should infants start taking HIV meds immediately after they're born?

Can an HIVer Live With One Kidney?
I'm scheduled to have my left kidney removed this week. How can I care for my HIV and my lone kidney at the same time? My viral load has been undetectable for six years on a regimen of abacavir (Ziagen) + nelfinavir (Viracept) + nevirapine (Viramune). Do I need to worry about the effects of medications and diet on my kidney?

Can I Catch Chicken Pox a Second Time Because I Have HIV?
I am an HIV-positive schoolteacher. My CD4 count is 218, and I started taking Atripla (efavirenz/tenofovir/FTC) this week. It was just announced that several students in my school have chicken pox. I know once you've had chicken pox, you're supposed to be immune to it. I had chicken pox as a child, but does HIV make it possible for me to catch it a second time from the kids?

• HIV TREATMENT

Resistance-Proof HIV Meds?
The last time I visited my doctor I was told that, in just the past few months, their office has seen eight new HIV-positive patients who are resistant to all available meds -- and none of them were older than 25. They are on a waiting list for three new drugs coming out next year, my nurse says. Now I'm wondering: Are there any drugs under investigation to which HIV could never become resistant?

Advice for a Former Injection Drug User on Taking (or Avoiding) T-20
I recently switched to a highly recommended HIV practice, and the doctors here want me to start taking T-20 (enfuvirtide, Fuzeon). The thing is, I'm a recovering injection-drug user, and the idea of starting to inject a drug again really frightens me. Is there anything I can suggest to my new doc that would allow me to avoid taking T-20?

My CD4 Count Is High, but My CD4 Percentage Is Low; What's Going On?
My most recent test results show that my CD4 count is quite high (1,100), but my CD4 percentage remains rather low (25 percent). My CD4 count has risen since my last test, but my CD4 percentage actually fell slightly. That seems odd to me. Should I be concerned? What's the relationship between CD4 count and CD4 percentage?

Can I Get HIV Drugs on the Internet?
I am writing on behalf of an HIV-positive friend I love very much. We're currently outside the United States, but I desperately want to help him get treatment. Ordering drugs through the Internet seems like a good option. Is there any way to do this?

Why Isn't My Regimen (Combivir + Tenofovir) Recommended for First-Line Treatment?
I've been told that Combivir (AZT/3TC) + tenofovir (Viread), the regimen I've taken since I began HIV treatment three years ago, is rarely used as a first-line treatment anymore. The regimen seems to work for me: Since I started, my viral load has remained below 50 and my CD4 count has been above 700. Can you tell me why my combo fell out of favor? Will my options be limited if it fails? I've been experiencing fatigue and memory problems and I seem to be getting fatter around the middle. If these are side effects of the drugs, should I consider stopping or switching?

Can I Take Atazanavir Without Ritonavir?
My doctor recently switched me from Combivir (AZT/3TC) + efavirenz (Sustiva, Stocrin) to atazanavir (Reyataz) + Epzicom (abacavir/3TC, Kivexa). One of my doctor's more experienced colleagues recommends boosting my new combo with ritonavir (Norvir). My doctor, however, insists that since my viral load is undetectable and my CD4 count is steady, there is no need to add ritonavir yet. Who's right?

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• COMPLICATIONS OF HIV & HIV MEDS

If I Have No Side Effects, Does That Mean My HIV Meds Aren't Working?
I recently tested positive for HIV and started taking Atripla (efavirenz/tenofovir/FTC). It's been about a week now, and I haven't had any side effects. Does this mean the drug isn't working?

Are There Any Fat-Loss Risks for Combivir + Nevirapine?
I've been on Combivir (AZT/3TC) + nevirapine (Viramune) for nine months and have had good results. However, I'm worried about the possibility developing fat loss on this regimen. How concerned should I be?

Trouble Swallowing After Starting Atripla
Not long after I started a new regimen of Atripla (efavirenz/tenofovir/FTC) + Kaletra (lopinavir/ritonavir), I began having trouble swallowing -- not in my throat, but down in my esophagus. I also developed a rash on my arms and legs, so my doctor discontinued my HIV meds and gave me a drug to treat my swollen esophagus. After a few days, the rash went away, but I'm still having a lot of trouble swallowing; I can only eat bland foods and have to drink a lot of water. Is there anything else that will help?

Juggling Side Effects and Chronic Depression: What Are My Treatment Options?
I'm a 40-year-old woman who's been living with HIV since 1995. My CD4 count is 500 and my viral load is 90,000. I've been off treatment since 2004, but I've recently been advised to start taking meds again. Do you agree? I'm also concerned about side effects: My last treatment resulted in body fat problems and high cholesterol levels, plus I also suffer from chronic depression. If I must restart treatment, what meds would work well for someone like me? Is efavirenz (Sustiva, Stocrin) recommended for an HIVer with mental health problems?

Is the Yellow Fever Vaccine Safe for HIVers?
I'm HIV positive and traveling to Kenya in late December. I was vaccinated for yellow fever in 1998, but I've lost the certificate. If I can't find a duplicate certificate I might need to get the inoculation again. Would that be dangerous?

• HIV TRANSMISSION

Is the AIDS Epidemic Over in the United States?
As World AIDS Day approaches, I've been hearing a ton about the AIDS epidemic in Africa and other resource-poor areas. What about the United States? No one seems to talk about AIDS here anymore. Do we have it under control?

From "Condoms-Shmondoms" to HIV Epiphany
I am a 37-year old, heterosexual, female nurse who has been negligent in practicing safe sex. "Condoms-shmondoms!" I used to say, but I've recently done an about-face. I changed specialties (from emergency medicine to blood disorders and cancer) and met several young, straight women who were diagnosed with HIV only after they ended up in the hospital with serious illnesses. I realized they could be me. The next time I had sex, I used a condom for the first time; unfortunately, it broke. I'm waiting anxiously to get an HIV test, but in the meantime, I met two women with cancer who probably only have a few months to live. I'm sure they'd quickly trade places with any HIVer for the chance to live years or decades instead of months. If you're a "worried well," be well, damn it, and direct your angst to help educate others and prevent the spread of HIV. If you've been diagnosed with HIV, as I well may be, live your life and be grateful for every day.

• HEPATITIS C

Hep C and Insurance: Can I Say I'm Negative if Treatment Cleared the Virus?
I recently went through 14 weeks of treatment for hepatitis C. I cleared the virus, and after six months I am still clear. Insurance and medical forms often ask the question, "Do you have hepatitis C?" How do I answer that now? Can I be denied insurance coverage since I had hep C?

• STRANGE BUT TRUE

Could Lipodystrophy Be Shrinking My Penis?
I've been on HIV meds for over twenty years. Lately, whenever I've gotten an erection, it seems far smaller than it used to be. I've had body fat changes from my meds, but my doctor says lipodystrophy doesn't affect the penis. What do you think?

Art From HIV-Positive Artists

Image from the November 2006 Visual AIDS Web Gallery

"Chipmunk Muffins," 1983;
Ronald Bruce Monroe

Visit the November 2006 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery is entitled "Hot Chicks and Others"; it's curated by Rocío Aranda-Alvarado, the curator at Jersey City Museum, where she organizes exhibitions of contemporary art featuring work by both established and emerging artists in the New Jersey and New York region.

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