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January 8, 2008

Living With HIV

HIV Treatment

You Your Labs

Complications of HIV HIV Meds

HIV Drug Resistance

HIV Hepatitis

Strange but True

• LIVING WITH HIV

Can Human Growth Hormone Improve an HIVer's Health?
I'm a 52-year-old HIVer who's not on meds yet. I want to stay as healthy as I can for as long as I can. Would taking human growth hormone help?

How Can a Civilized Country Ban HIV-Positive Travelers?
I'm an HIV-positive Brazilian living in London. I've traveled all over Europe, and my HIV status has never been an issue. I'd love to travel to New York, but U.S. immigration law makes it difficult for me to visit unless I smuggle in my meds like a terrorist hiding a bomb! The United States' travel restrictions on people with HIV are shameful. Why haven't U.S. HIV activists demanded an end to the travel ban?

Can a Person With HIV Make It Through Medical School?
I've been considering going to medical school to study infectious diseases, but my family thinks it's foolish for a person with HIV to chase this dream. Could an HIV-positive person complete the eight-year course of study necessary to become a doctor? If I go through with this plan, do you have any advice on how I should protect my health while I pursue it?

• HIV TREATMENT

My CD4 Count Is 167; Should I Keep Taking "Immunity Boosters" or Start HIV Meds?
Though I've been HIV positive for five years, I haven't started treatment yet. Because my CD4 count was 147 last June, I started taking drugs to boost my immunity. In October my CD4 count was 167. Can I continue to use these "immunity boosting" drugs, or should I start taking HIV meds?

Seeing a Doctor Who Is Not Experienced With HIV
When I moved from Los Angeles to the Mojave Desert, I began seeing a doctor who is not knowledgeable about HIV. He has me on a regimen of Sustiva (efavirenz, Stocrin) and Truvada (tenofovir/FTC), which I take every three days because he said to do whatever works best for me. The earliest I will be able to see an HIV specialist is the end of March. To tide me over until then, a friend recommended that I simply decide what HIV drug regimen I want to take and have the doctor write the prescription. What would you suggest?

• YOU AND YOUR LABS

Can CD4 Count Vary Due to Fasting?
I have been HIV positive since 1996, with an undetectable viral load since 1998. I have noticed that my CD4 count tends to drop as many as 150 points when I have been fasting. For example, it dropped from 657 in September 2007, when I wasn't fasting, to 495 in January 2008, when I was. Is there any correlation between fasting and fluctuations in CD4 count?

• COMPLICATIONS OF HIV HIV MEDS

Is My Son at Increased Risk for Non-Hodgkin's Lymphoma?
My 28-year-old son tested HIV positive last month. He now has some sniffles and slightly swollen glands. He previously had Epstein-Barr -- does this fact plus his HIV status put him at a higher risk for developing non-Hodgkin's lymphoma?

• HIV DRUG RESISTANCE

How Risky Is It to Continue Taking a Drug I'm Resistant To?
I began taking Combivir (AZT/3TC) and Sustiva (efavirenz, Stocrin) ten days ago, before my doctor and I got the results of my first resistance test. When the results came back, I learned that I have the M184V mutation, which indicates resistance to 3TC, a component of Combivir. I can't switch meds for another week because I'm working abroad and don't have access to HIV meds here. Will my 3TC resistance make me resistant to Sustiva, too, before I am able to change my regimen?

I Mixed Up My Dosing Schedule Over the Holidays; Am I in Trouble?
I've been taking Truvada (tenofovir/FTC) and Sustiva (efavirenz, Stocrin) for four months. My viral load has dropped from 430,000 to 90 and my CD4 count has increased from 100 to 350. While staying with friends who don't know my HIV status, I took my meds in a rush and accidentally took a second dose of Sustiva and missed a dose of Truvada. How likely is that to cause HIV drug resistance?

My Husband Always Takes His Meds; How Could He Have Developed Drug Resistance?
My husband has been taking Kaletra (lopinavir/ritonavir) and Viramune (nevirapine) twice a day since October 2002. His adherence has been excellent, but his last set of lab tests showed that his viral load had spiked from undetectable to about 3,000. His doctor suspects drug resistance and ordered a resistance test. I'm surprised that resistance could develop so quickly in a person who has taken his meds so consistently. Are there any other explanations?

Another Nasty Side Effect of Club Drugs: Forgetting Your HIV Meds
Dr. Bob: In response to a question about taking ecstasy while on HIV meds, you mentioned the potential side effects of club drugs. Yet you didn't discuss another consequence of drug use that can be equally dangerous: Regularly using recreational drugs may make it difficult for people with HIV to take their HIV meds consistently. This can increase your risk of developing drug resistance, experiencing treatment failure and having less treatment options in the long term.

• HIV HEPATITIS

I've Been Diagnosed With Hep C; Do I Need to Change My HIV Meds?
I've been HIV positive for 20 years (or more), and I have a CD4 count of 700 and an undetectable viral load. I was just diagnosed with hepatitis C, and I don't have a swollen liver and have not been prescribed any medication for it. However, I'd like to change my HIV meds so they won't affect my liver. Do you have any recommendations? Is it safe to take Truvada (tenofovir/FTC) with Isentress (raltegravir, MK-0518)? I read that even though Truvada is processed by the kidneys, it can damage the liver.

• STRANGE BUT TRUE

Finding Out About HIV the Hard Way
I found Combivir (AZT/3TC) and Sustiva (efavirenz, Stocrin) in my boyfriend's luggage. Does this mean he has HIV, or are those drugs used to treat other illnesses, too?

Is My Semen a "Limited Time Only" Offer?
I masturbate on a very regular basis. Will I run out of semen?

Art From HIV-Positive Artists

"Portrait of Michael Wilson (II)," 1988; Bern Boyle

Visit the brand new January 2008 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery, entitled "Re-Imagined Boundaries," is curated by the New York University Tisch High School Photography Program.

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