I have no doubt what so ever that sculptra had nothing to do with your face
swelling.
You see sculptra is slowly digested by the body in less then one year, as such
it would be
impossible for you to have an allergic reaction to something that is no longer
in your body.
The most comon misconception is that sculptra is a filler, it is not, sculptra
stimulate ones
body to produce collagen.
Polylactic acid (sculptra has been used now for 40 years world wide to both
correct
unwanted side effects from surgery and to make dissolving stitches used after
minor
surgeries, to my knoledge there have never been any cases of relevant side
effects
including allergies to polylactic acid.
In fact it was the above that made me choose sculptra 4 years ago to correct my
face,
it is as safe as it can be and it gave me back my own face, no filler, my own
nerves and
veins running in my own face, it simply doesn't get any better then that.



--- In PozHealth@yahoogroups.com, "t a" <tarantxx@m...> wrote:
> I had my face treated in November of 2001 by Dr. Frechette.  He massaged my
face and
so did I as he had told me to do.  Suddenly, in February of 2003, my face swell
up.  If
someone would have seen me for the first time, they probably would not have
noticed it
but people who knew me, saw the difference.  I went back to Dr. Frechette who
gave me
some injections of cortison and that took care of the swelling. He or I had no
idea why I
had this late reaction such a long time after the treatments (I had 2)  but
could not think of
anything else that could have caused it.  Scultra or Newfill as it was called
then lasted well
over 2 years.  If I were willing to spend money again, I would still use
sculptra, even after
the "allergic" reaction I had.  My opinion is that the lumping has less to do
with the doctor
and more with the individual patient's tolerance.
> Brigitte
>
>   ----- Original Message -----
>   From: PozHealth@yahoogroups.com<mailto:PozHealth@yahoogroups.com>
>   To: PozHealth@yahoogroups.com<mailto:PozHealth@yahoogroups.com>
>   Sent: Saturday, April 02, 2005 12:32 PM
>   Subject: [PozHealth] Digest Number 974
>
>
>
>
>   There are 10 messages in this issue.
>
>   Topics in this digest:
>
>         1. Avascular Necrosis Risk Factors-steroids, alcohol
>              From: JuLev@a...<mailto:JuLev@a...>
>         2. Re: More on abacavir-induced neuropsychiatric reactions
>              From: Mike DC <mikedcguy@y...<mailto:mikedcguy@y...>>
>         3. Sculptra and Dr. Frechette
>              From: Sotoway@a...<mailto:Sotoway@a...>
>         4. Re: cheekbone implants
>              From: Fit4fundc@a...<mailto:Fit4fundc@a...>
>         5. Two good suggestions from a member
>              From: PoWeRTX@a...<mailto:PoWeRTX@a...>
>         6. Abdominal Adiposity the Best Predictor of Type 2 Diabetes in Men
>              From: beefymusclebud@a...<mailto:beefymusclebud@a...>
>         7. One stop patient assistence, this is important
>              From: beefymusclebud@a...<mailto:beefymusclebud@a...>
>         8. Assessing the Relationship Between Fatigue and Mitochondrial
Toxicity in Patient
>              From: PoWeRTX@a...<mailto:PoWeRTX@a...>
>         9. MRI to assess facial wasting and AVN
>              From: PoWeRTX@a...<mailto:PoWeRTX@a...>
>        10. HIV Transplant study website
>              From: PoWeRTX@a...<mailto:PoWeRTX@a...>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 1
>      Date: Thu, 31 Mar 2005 17:00:37 EST
>      From: JuLev@a...<mailto:JuLev@a...>
>   Subject: Avascular Necrosis Risk Factors-steroids, alcohol
>
>   NATAP - www.natap.org<http://www.natap.org/>
>
>   Avascular Necrosis in HIV-Infected Patients:
>   A Case-Control Study from the Aquitaine Cohort, 1997-2002, France
>
>   “…… This comparative analysis (CID 4/2005) investigating a wide range
of
>   factors revealed that current alcohol use and a history of steroid use were
>   strongly associated with the occurrence of AN….history of steroid use was
>   independently associated with a high risk of AN…...even short courses of
steroid
>   treatment increased this risk substantially….the first line of prevention
of this
>   bone disorder in HIV-infected patients should be the cessation of alcohol
>   consumption and the limitation of steroid prescription….Although it has
been
>   speculated that receipt of HAART is associated with the occurrence of AN, no
>   association between this bone disorder and the receipt or duration of
antiretroviral
>   therapy has been observed in the present comparative
study…….Hypertriglycemia
>   or hypercholesterolemia were not found to be predisposing factors, as is
>   described in the literature. In the present study, more case patients
presented
>   with high total cholesterol levels than did control subjects, and the number
of
>   case patients with hypertriglyceridemia was 5-fold greater than the number
of
>   control subjects with hypertriglyceridemia…….�? see author 'Discussion
Below'
>
>   Clinical Infectious Diseases April 2005;40:1188-1193
>
>   Sylvie Lawson-Ayayi,1,2 Fabrice Bonnet,1,2 Elise Bernardin,1 Jean-Marie
>   Ragnaud,2 Denis Lacoste,2 Denis Malvy,2 Marie-Josée Blaizeau,2 Ghada M
>   iremont-Salamé,3 Michel Dupon,2 Patrick Mercié,1,2 and François Dabis,1,2
for
the Groupe
>   d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA)a
>
>   1Institut National de la Santé et de la Recherche Médicale Unité 593,
>   Institut de Santé Publique, d'Epidémiologie et de Développement, and
2Centre
>   d'Information et de Soins de l'Immunodéficience Humaine, and 3Centre
Régional
de
>   Pharmacovigilance, Département de Pharmacologie, Equipe d'Accueil 3676,
Centre
>   Hospitalo-Universitaire de Bordeaux, Bordeaux, France
>
>   Using a case-control study design, we studied the factors associated with
>   HIV-related avascular necrosis (AN). During a 6-year period, 12 symptomatic
AN
>   cases were validated, and each case was individually matched with 3 control
>   cases. A conditional logistic regression model showed that current alcohol
>   consumption and a history of steroid use were the only factors associated
with the
>   occurrence of AN.
>
>   Since HAART was introduced and its use has become widespread in
>   industrialized countries, rates of mortality and severe morbidity related to
HIV infection
>   have been drastically reduced. Although survival rates and quality of life
>   have improved among HIV-infected individuals, adverse consequences of
long-term
>   exposure to antiretroviral regimens have emerged [1-4]. Particularly,
metabolic
>   complications have been diagnosed in HIV-infected patients who are treated
>   with HAART, and they have been associated with the receipt of protease
>   inhibitors (PIs) and nonnucleoside reverse-transcriptase inhibitors (NNRTIs)
[5-8].
>   More recently, cases of avascular necrosis (AN), also referred to as
>   osteonecrosis, have been reported [9-20], but few studies have reported an
increased
>   incidence of this severe bone disorder [3, 4]. The incidence of asymptomatic
AN
>   among HIV-infected patients was estimated to be 4.4%, through systematic
>   screening with MRI [21]. The annual incidence of AN, whether symptomatic or
not, in
>   the general population has been estimated to be between 0.010% and 0.135%
[15,
>   22-24]. Thus, the incidence of AN among HIV-infected adults has been found
to
>   be 〜45 times greater than the incidence in the general population [15],
which
>   suggests that its occurrence is a consequence of or a complication of either
>   HIV infection or receipt of HAART [25].
>
>   Several risk factors and conditions, such as hyperlipidemia, alcohol abuse,
>   steroid use, pancreatitis, and underlying vascular diseases, have been
>   postulated to be associated with AN [14, 26]. Case reports also have
suggested that
>   HIV infection and antiretroviral therapy, particularly HAART regimens, could
>   also be risk factors for AN, independent of underlying comorbidities [17];
>   however, to our knowledge, no systematic study has been conducted thus far.
We
>   studied the main known and hypothesized risk factors for symptomatic cases
of AN
>   that were identified in a large cohort of HIV-infected patients.
>
>   Results.      Through December 2002, a total of 12 symptomatic AN cases were
>   identified and validated. Eleven of the 12 cases were in men. The median age
>   of the case patients was 38.3 years (interquartile range [IQR], 36.2-45.2),
and
>   9 case patients had received a diagnosis of AIDS. The median time since
>   diagnosis of HIV infection was 10.4 years (IQR, 8.6-12.9). All case patients
had
>   been exposed to HAART (consisting of at least 3 antiretroviral drugs,
including
>   a PI or an NNRTI) before the occurrence of AN. Criteria used for matching
had
>   comparable values in the case and control groups at baseline: median ages
were
>   38.3 years and 38.4 years, respectively (P = .83); median CD4+ cell counts
at
>   the time of diagnosis of HIV infection were 266.5 cells/mL and 272.0
>   cells/mL, respectively (P = .66); and median durations of HIV infection
since the time
>   of diagnosis were 123.0 months and 125.1 months, respectively (P = 94).
>
>   In univariate analyses, case patients were more likely than control subjects
>   to be men who reported sex with men, to have fat accumulation, and to engage
>   in regular or heavy alcohol use, according to physicians' reports. Neither
>   receipt of a specific antiretroviral drug nor the duration of HAART was
associated
>   with AN. However, history of intravenous or oral course of steroid treatment
>   was associated with AN occurrence at a borderline level of statistical
>   significance.
>
>   In the multivariate analyses, the only adjusted matched OR (aOR) >1 was for
>   alcohol consumption (P = .02). Statistical association appeared to be of
>   borderline significance in the reduced model with regard to fat accumulation
(P =
>   .07) and receipt of efavirenz, ritonavir, or nelfinavir (P = .08, P = .05,
and P
>   = .09, respectively).
>
>   When all factors identified by the 2 initial multivariate analyses were
>   combined in the final model, the risk of the occurrence of AN remained
>   significantly associated with alcohol consumption (aOR, 20.48; 95% CI,
1.83-229.72; P
=
>   .01) and history of steroid use (aOR, 16.96; 95% CI, 1.20-239.12; P = .04),
>   whereas fat accumulation failed to be associated with the occurrence of AN
(aOR,
>   22.67; 95% CI, 0.69-745.95; P = .08).
>
>   Author Discussion
>   This comparative analysis investigating a wide range of factors revealed
that
>   current alcohol use and a history of steroid use were strongly associated
>   with the occurrence of AN. The findings of the present study also provided a
>   presumption of an association of AN with fat accumulation. The association
of the
>   occurrence of AN with receipt of HAART or the individual components of HAART
>   was not confirmed. Despite the fact that a trend for association with AN was
>   detected for receipt of individual drugs, receipt of PIs or NNRTIs , when
>   considered as cumulative exposure before the diagnosis of AN, could not be
>   identified as having an association with the occurrence of AN. Nevertheless,
the role
>   of antiretroviral therapy, if any, is probably limited, compared with the
roles
>   of steroid use and alcohol use.
>
>   Hypertriglycemia or hypercholesterolemia were not found to be predisposing
>   factors, as is described in the literature [23, 28]. In the present study,
more
>   case patients presented with high total cholesterol levels than did control
>   subjects, and the number of case patients with hypertriglyceridemia was
5-fold
>   greater than the number of control subjects with hypertriglyceridemia (data
not
>   shown). The potential link between hyperlipidemia and AN supports the
>   hypothesis that the use of PIs is implicated, through an increase of serum
lipid
>   levels, in the occurrence of AN [29]. Scribner et al. [22] have suggested
that
>   moderate hypertriglyceridemia is an independent risk factor for the
occurrence of
>   AN but that severe hypertriglyceridemia is more likely to be associated with
>   AN by means of PI therapy.
>
>   Previous studies have concluded that HIV infection alone may be a risk
factor
>   for AN [28, 30]. Although it has been speculated that receipt of HAART is
>   associated with the occurrence of AN [10], no association between this bone
>   disorder and the receipt or duration of antiretroviral therapy has been
observed in
>   the present comparative study. This is possibly because antiretroviral
>   therapy is widely used in hospital-based cohorts with unlimited access to
care, as
>   is the case in France. The lack of an association between the receipt of PIs
>   and the occurrence of AN has been observed in other studies, as well [16,
21,
>   24, 31].
>
>   Steroid use and alcohol abuse are the most common risk factors associated
>   with AN [26]. Indeed, in the present study, a history of steroid use was
>   independently associated with a high risk of AN, and the association did
persist when
>   the analysis was adjusted for other variables. This result confirmed
findings
>   of previous case-control studies that reported an association between
steroid
>   use and the occurrence of AN but could not control for as many factors as we
>   did in the present analysis [22, 31]. Miller et al. [21] indicated that even
>   short courses of steroid treatment increased this risk substantially. In the
>   present study, "alcohol use" was defined as the consumption of any
combination of
>   different types of alcohol (wine, beer, and cocktails). Because French
>   consumers usually record a more regular intake of alcoholic beverages than
do
>   consumers elsewhere in the world, we considered regular or heavy drinkers to
be the
>   "high-exposure" category. The estimation of this risk factor by physicians
>   from patients' self-reported behavior could have introduced a bias that is a
>   common limitation of studies on alcohol intake. We could not investigate
>   hereditary vascular diseases-in particular, the presence of antiphospholipid
>   antibodies, which may contribute to the occurrence of AN, given its high
prevalence
>   among HIV-infected patients [32].
>
>   To our knowledge, the present analysis is the first to investigate the
>   contribution of antiretroviral therapy to the occurrence of AN in detail and
by use
>   of a powerful comparative design, and the first to finally rule out its
role.
>   HIV-infected patients with asymptomatic cases of AN were not included in the
>   present study, because of the system we used to find cases. Thus, we
evaluated
>   only symptomatic cases of AN, and our findings should not be extrapolated to
>   all cases of AN. Because the limited number of cases may have affected the
>   outcome of the present study, large, collaborative epidemiological studies
are
>   still needed to confirm our results and to fully evaluate the role of
>   antiretroviral therapy in AN, symptomatic or not. Finally, the mechanisms
that lead to
AN
>   in HIV-infected patients must also be determined. In the interim, the first
>   line of prevention of this bone disorder in HIV-infected patients should be
the
>   cessation of alcohol consumption and the limitation of steroid prescription.
>
>   Patients and methods.      We performed a case-control study nested within
>   the Aquitaine Cohort [27]. The Aquitaine Cohort comprises patients enrolled
>   through a hospital-based surveillance system of HIV infection in
southwestern
>   France. Beginning in 1987, adult inpatients and outpatients were enrolled
>   prospectively in the present case-control study if they were referred by
participating
>   hospital wards, had confirmed HIV-1 infection and at least 1 follow-up visit
>   after enrollment or a documented date of death after initial reporting, and
>   provided informed consent. Follow-up is based on clinical practice; a
>   standardized reporting form for epidemiological, clinical, biological, and
therapeutic
>   data is completed by physicians at the time of each hospital contact, which
>   generally occur every 3 or 6 months or in the case of any intercurrent
event.
>
>   All symptomatic cases of AN that were reported through December 2002 through
>   either the cohort monitoring system or the pharmaco-epidemiology information
>   system maintained by the Bordeaux University Hospital were systematically
>   investigated. These 2 reporting systems allowed us to identify AN cases that
had
>   been diagnosed by physicians since the first AN case notification in 1997.
>   Symptomatic AN cases were detected on the basis of clinical symptoms and
confirmed
>   by radiological or scintigraphical imaging. For each patient with a
confirmed
>   case, we randomly selected 3 control subjects from the Aquitaine Cohort
>   database who showed no clinical evidence of AN and who could be matched on
the
basis
>   of age (±3 years), time since the diagnosis of HIV infection (±2 years),
CD4+
>   cell count at the time of diagnosis of HIV infection (i.e., <200 cells/mL,
>   200-349 cells/mL, 350-499 cells/mL, or &ges;500 cells/mL), and duration of
>   follow-up after the diagnosis of HIV infection. Information on demographic
>   characteristics, clinical data, biological values, and antiretroviral
therapy use were
>   retrieved from the database for case patients and control subjects and were
>   systematically verified using clinical records for the purpose of the
present
>   study.
>
>   Association of the occurrence of AN with a given variable was estimated by
>   the matched odds ratio (OR). A conditional logistic regression model was
used to
>   analyze the simultaneous effects of several independent factors. A variable
>   was included in the multivariate model if it was associated with the
occurrence
>   of AN at a statistical significance of P < .25 in univariate analysis.
>   Because of the small number of observations relative to the number of
variables, 2
>   models were first developed: one model with demographic, clinical, and
>   biological variables, and the other with variables relating to
antiretroviral therapy.
>   In each model, a backward stepwise procedure was applied to remove variables
>   that were not significantly associated with the occurrence of AN. A forward
>   selection was then applied for the robustness of the analysis. The variables
>   that were retained in the 2 separate models were included in a final model.
>   Models were fitted using STATA software, version 5.0 (Stata).
>
>   REFERENCES
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>   18.      Valencia ME, Barreiro P, Soriano V, Blanco F, Moreno V, Lahoz JG.
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>   case-control study. J Acquir Immune Defic Syndr 2000; 25:19-25. First
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>   23.      Allison GT, Bostrom MP, Glesby MJ. Osteonecrosis in HIV disease:
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>   necrosis of the hip in HIV-infected patients. J Acquir Immune Defic Syndr
>   2001; 28:101-2. First citation in article | PubMed
>   25.      Monier P, McKown K, Bronze MS. Osteonecrosis complicating highly
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>   virus. Clin Infect Dis 2000; 31:1488-92. First citation in article | Full
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>   PubMed
>   26.      Blacksin MF, Kloser PC, Simon J. Avascular necrosis of bone in
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>   immunodeficiency virus infected patients. Clin Imaging 1999; 23:314-8. First
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>   immunodeficiency virus infection and AIDS in Aquitaine: 10 years' experience
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>   en Aquitaine (GECSA) [in French]. Presse Med 1997; 26:703-10. First citation
>   in article | PubMed
>   28.      Ries MD, Barcohana B, Davidson A, Jergesen HE, Paiement GD.
>   Association between human immunodeficiency virus and osteonecrosis of the
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>   head. J Arthroplasty 2002; 17:135-9. First citation in article | PubMed
>   29.      Bonfanti P, Grabbuti A, Carradori S, et al. Osteonecrosis in
>   protease inhibitor-treated patients. Orthopedics 2001; 24:271-2. First
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>   patients may not be related to immune reconstitution. Clin Infect Dis 2001;
>   33:268-9. First citation in article | Full Text | PubMed
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>   32.      Bonnet F, Pineau JJ, Taupin JL, et al. Prevalence of
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>   infected individuals: a cross-sectional study of 97 patients. J Rheumatol
2003;
>   30:2005-10. First citation in article | PubMed
>
>
>
>   [This message contained attachments]
>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 2
>      Date: Thu, 31 Mar 2005 14:52:57 -0800 (PST)
>      From: Mike DC <mikedcguy@y...<mailto:mikedcguy@y...>>
>   Subject: Re: More on abacavir-induced neuropsychiatric reactions
>
>
>   This is all VERY INTERESTING.  I tried Sustiva and
>   couldn't stand it.  My doctor then tried Abacavir, and
>   I told him I still felt "messed up," so we stopped
>   that as well.  This was all a few years ago.
>   At the time, my doctor told me that Abacavir wasn't
>   known to have such side effects.  I felt very
>   disoriented on the stuff.  Thanks Nelson for posting
>   all of this on Abacavir - it feels like a mystery has
>   been solved (and I feel slightly vindicated).  These
>   meds really can have a range of side effects for
>   diffent people. OH well ...
>
>
>   --- PoWeRTX@a...<mailto:PoWeRTX@a...> wrote:
>
>   > This happened  to me also. I know several  people
>   > that have had the same
>   > problem on Ziagen. Doctors and patients do not  know
>   > about this.
>   > More on abacavir-induced neuropsychiatric reactions.
>   >
>   > Foster R, Taylor C, Everall IP.
>   > AIDS. 2004 Dec 3;18(18):2449.
>   > It is increasingly recognized that  antiretroviral
>   > medications may induce
>   > severe, but transient, changes in mental  state.
>   > These are uncommon and
>   > idiosyncratic, with the literature containing only
>   > two published reports suggesting
>   > that abacavir (Ziagen), a nucleoside reverse
>   > transcriptase inhibitor, may
>   > induce a range of neuropsychiatric disorders in
>   > seropositive individuals. These
>   > include depression, suicidal thoughts, auditory
>   > hallucinations [_1_
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e<http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/
ovidweb.cgi?QS2=434f4e1a73d37e>
>   >
>
8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d35fcac6cd23743905e8
d6761
>   >
>
84e808855bd7f415e7acd48b9da8092db6e57b008cbb2cb6d164cd511242a35a0302af53
4fa8b6
>   > #17) ]  and frank psychosis [_2_
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d154<http://
gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d154>
>   >
>
97b83b9e5baab68f6262d35fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da8
092db
>   > 6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6#18) ].
>   >  Of note is the fact
>   > that the subjects in these cases were all female
>   > with CD4  cell counts below 500
>   > cells/µl. Here we report, for the first time, a
>   > case of a  possible
>   > abacavir-induced neuropsychiatric reaction in a
>   > seropositive Caucasian  man with a
>   > higher CD4 cell count.
>   > The patient was a 44-year-old gay man who was
>   > diagnosed HIV positive in
>   > 1993. He was referred to psychiatric services in
>   > 2000  after the psychologist whom
>   > he had been seeing became concerned about the
>   > patient's ongoing depressive
>   > symptoms. He had previously been treated with
>   > various antidepressants and
>   > triple therapies for HIV, and was currently
>   > receiving citalopram 30 mg a day in
>   > addition to tenofovir 245 mg per day,  nevirapine
>   > 200 mg twice a day and
>   > abacavir 300 mg twice a day. He had previously  been
>   > taking didanosine, but this was
>   > changed to abacavir because of  lipodystrophy.
>   > Approximately one week after commencing  abacavir,
>   > the patient started to
>   > complain of feeling tired and ‘stoned'. He also
>   > complained of headaches, which
>   > were described as ‘constant and throbbing’ and
>   > ‘located in the middle of my
>   > brain'. He reported the onset of bad dreams, which
>   > he referred to as ‘night
>   > terrors'. These were described as vivid and
>   > terrifying,  but the actual content
>   > could not be recalled. He denied any associated
>   > physical  symptoms such as
>   > night sweats or any recent physical illness. His CD4
>   > cell count  at this time was
>   > 557 cells/µl and his viral load was less than 50
>   > copies/ml. Of  note is the
>   > fact that despite his dreams he now felt that his
>   > previously low  mood had
>   > improved to the extent that he was expressing the
>   > desire to cease  taking
>   > citalopram.
>   > Two weeks after reporting the above problems,  the
>   > patient was reviewed by
>   > the HIV physician who changed the abacavir back to
>   > didanosine. Within 24 h of
>   > this the patient reported that his headaches and bad
>   >  dreams had stopped, and
>   > that he was feeling less fatigued. At one month
>   > follow-up he remained free of
>   > these symptoms, and his mood remained settled. The
>   > citalopram was eventually
>   > reduced gradually and finally stopped.
>   > This case suggests that abacavir may, in rare
>   > cases, induce unpleasant but
>   > non-specific neuropsychiatric side-effects, which
>   > can resolve rapidly upon
>   > stopping this medication. Although it has been
>   > suggested that abacavir may be
>   > associated with new-onset depression [_1_
>   > (http://gateway.ut.ovid.com.ezproxyhost.library<http://
gateway.ut.ovid.com.ezproxyhost.library/>.
>   >
>   tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d
35fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da
>   >
>   8092db6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6#17)
>   > ],  this was not
>   > apparent in the current case. In that earlier
>   > publication [_1_
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3<http://
gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3>
>   >
>
ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d35fcac6cd23743905e8d676184
e80885
>   >
>
5bd7f415e7acd48b9da8092db6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6#17
)
>   > ],
>   >  depression and night sweats were reported in one
>   > patient, with depression,
>   > suicidal ideation, headache, auditory hallucinations
>   > and anorexia in the
>   > second.  The patients in those cases were both HIV
>   > positive Caucasian women.
>   > Similarly, a  more recent publication described a
>   > case of putative abacavir-induced
>   > psychosis  occurring in an African woman [_2_
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b5<http://
gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b5>
>   >
>
3d5e5632d15497b83b9e5baab68f6262d35fcac6cd23743905e8d676184e808855bd7f41
5e7acd
>   >
>   48b9da8092db6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6#18)
>   > ]  who became
>   > symptom-free after the cessation and substitution of
>   > this  medication.
>   > The current report suggests that men can also  be
>   > adversely affected by
>   > abacavir-associated neuropsychiatric problems, even
>   > at  a higher CD4 cell count
>   > accompanied by a low viral load. Furthermore,
>   > symptoms  may rapidly resolve upon
>   > discontinuation of abacavir and the substitution of
>   > a  suitable alternative
>   > antiretroviral agent. It is possible that headache
>   > and mood  alterations may be
>   > early indicators of neuropsychiatric sequelae
>   > associated with  abacavir. These
>   > should be investigated and monitored closely to
>   > exclude possible  organic
>   > factors. Management should be carried out in
>   > collaboration with both HIV
>   > physicians and specialist psychiatrists.
>   > References
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d
3<http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d
3>
>   >
>
5fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da8092db6e57b008cbb2cb6d
164cd5
>   > 11242a35a0302af534fa8b6#toc)
>   > 1. Colebunders R, Hilbrands R, De Roo A, Pelgrom J.
>   > Neuropsychiatric reaction
>   > induced by abacavir.  Am J Med 2002; 113:616.
>   > _ExternalResolverBasic_
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
Link+Set+Ref=0<http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/
ovidweb.cgi?Link+Set+Ref=0>
>   >
>   0002030-200412030
-00021|00000439_2002_113_616_colebunders_neuropsychiatric_|00
>   >
>   002030-200412030-00021#xpointer(id(R1-21))|1103920|http://acs.ovid.com/acs/
.f6
>   >
>
489bf4937db0b6e5a4e52b4a0f690866ea468998ca8e6ac6e6d949d499ba8ceb07ec98d25
42738
>   >
>
eb60d9d5afd443af26842fbd2b397e36e9ea7cf26a19744cf8bf2cf6fefeecf6eb.gif|ovftdb|
>   >
>   00000439-200211000
-00018&P=17&S=IDNJHKJKBAMCKK00D&WebLinkReturn=Full+Text=L|S.
>   > sh.15.16|0|00002030-200412030-00021)
>   > _Bibliographic  Links_
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
Link+Set+Ref=00002030<http://gateway.ut.ovid.com.ezproxyhost.library.tmcedu/gw2/
ovidweb.cgi?Link+Set+Ref=00002030>-
>   >
>   200412030
-00021|00000439_2002_113_616_colebunders_neuropsychiatric_|00002030-2
>   >
>  
00412030-00021#xpointer(id(R1-21))|60|http://acs.ovid.com/acs/.6f8cf7c31ada011
>   >
>
97afb0a1ba3d293b287b71168019f9ea6ec0cdc7f51235e3420b469cc1e8a8406f3c6be4f1
4376
>   >
>   dfd09416d1f878f23bb78.gif|ovftdb|00000439-200211000
-00018&P=17&S=IDNJHKJKBAMCK
>   >
>   K00D&WebLinkReturn=Full+Text=L|S.sh.15.16|0|00002030-200412030-00021)
>   >
>   > _[Context  Link]_
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d
3<http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d
3>
>   >
>
5fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da8092db6e57b008cbb2cb6d
164cd5
>   > 11242a35a0302af534fa8b6#10)
>   > 2. Foster R, Olajide D, Everall IP. Antiretroviral
>   > therapy-induced psychosis:
>   > case report and brief  review of the literature. HIV
>   > Med  2003; 4:139�"144.
>   > _[Context  Link]_
>   >
>   (http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f62<ht
tp://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?
QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f62>
>   >
>
62d35fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da8092db6e57b008cbb2
cb6d16
>   > 4cd511242a35a0302af534fa8b6#10) Accession Number:
>   > 00002030-200412030-00021
>   >
>   > In  health,
>   >
>   > Nelson Vergel
>   > Director
>   > Program for Wellness Restoration,  PoWeR
>   > A 501 (c) 3 non profit national  organization
>   > powerusa.org
>   > salvagetherapies.org
>   > faciawasting.org
>   >
>   >
>   > Disclaimer
>   >
>   > This  information (and any accompanying printed
>   > material) is not intended to
>   > replace  the attention or advice of a physician or
>   > other health care
>   > professional. Anyone  who wishes to embark on any
>   > dietary, drug, exercise, or other
>   > lifestyle change  intended to prevent or treat a
>   > specific disease or condition
>   > should first  consult with and seek clearance from a
>   > qualified health care
>   > professional.
>   >
>
>
>   __________________________________________________
>   Do You Yahoo!?
>   Tired of spam?  Yahoo! Mail has the best spam protection around
>   http://mail.yahoo.com<http://mail.yahoo.com/>
>
>
>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 3
>      Date: Thu, 31 Mar 2005 19:28:51 EST
>      From: Sotoway@a...<mailto:Sotoway@a...>
>   Subject: Sculptra and Dr. Frechette
>
>   Hi All;
>
>   I had my second treatment with the great Doctor my face appears completely
>   restored.  It was a bit uncomfortable, but worth the discomfort.  I 
strongly
>   recommend him.  He is patient and shows great deal of  expertise.  I believe
>   that the massage and cold ice treatment play a big  role in the prevention
of
>   bumps under the skin that a lot of you have been  complaining about.  If
anyone
>   can wants to see him he has an office in New  york as well as San Francisco.
>
>
>   Nancy
>
>
>   [This message contained attachments]
>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 4
>      Date: Thu, 31 Mar 2005 21:15:18 EST
>      From: Fit4fundc@a...<mailto:Fit4fundc@a...>
>   Subject: Re: cheekbone implants
>
>   Cheek implants have their advantages too.   The implants can be trimmed.
They
>   come in different sizes and shapes.   If you don't like the really wide ones
>   but you like the fact that it is very thick, the surgeon can trim it so it
>   isn't so wide.   My surgeon inserted the largest pair and they were still a
>   little to wide for me.    They gave me too much of a cheek and too wide up
near my
>   eye socket and to the side of my face.   I had a few infections and one had
to
>   be removed twice.   If I had it to do all over, I would opt for only the
>   fillers like BioAlcamid.
>
>   Cheek implants can change the look of your face to something you never
looked
>   like.   Personally, I like long hard faces on men.   My cheeks implants made
>   me more rounded, not what I really wanted.   However, they did fill up the
>   thumb prints in my face.
>
>   It's a hard choice sometimes.
>
>
>   Lester in DC
>
>
>   [This message contained attachments]
>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 5
>      Date: Thu, 31 Mar 2005 21:50:21 EST
>      From: PoWeRTX@a...<mailto:PoWeRTX@a...>
>   Subject: Two good suggestions from a member
>
>
>       *   Rather than copy a whole article  onto this yahoo group if you could
>   give the name of the article (and topic if  not evident in the name), what
you
>   found interesting and the URL where to  find the complete article along with
>   the source information.
>       *   When replying to a message delete everything  below the first line
of
>   the message you are replying to, as it shows up  numerous times for the
>   person who has subscribed to this group to receive the  emails in digest
form.  If
>   you leave the sender, subject and first line  of the message almost anyone
>   would understand what message you are responding  to.
>
>
>   In  health,
>
>   Nelson Vergel
>   Director
>   Program for Wellness Restoration,  PoWeR
>   A 501 (c) 3 non profit national  organization
>   powerusa.org
>   salvagetherapies.org
>   faciawasting.org
>
>
>   Disclaimer
>
>   This  information (and any accompanying printed material) is not intended to
>   replace  the attention or advice of a physician or other health care
>   professional. Anyone  who wishes to embark on any dietary, drug, exercise,
or other
>   lifestyle change  intended to prevent or treat a specific disease or
condition
>   should first  consult with and seek clearance from a qualified health care
>   professional.
>
>
>   [This message contained attachments]
>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 6
>      Date: Thu, 31 Mar 2005 23:30:51 EST
>      From: beefymusclebud@a...<mailto:beefymusclebud@a...>
>   Subject: Abdominal Adiposity the Best Predictor of Type 2 Diabetes in Men
>
>
>   Abdominal Adiposity the Best Predictor of Type 2 Diabetes in  Men
>
>
>   NEW YORK Mar 31 - Both overall obesity, denoted by higher BMI, and abdominal
>   obesity, reflected by higher waist circumference strongly and independently
>   predict risk of type 2 diabetes in men, but abdominal obesity appears to be
>   the  better predictor, new research shows.
>   "Both BMI and waist circumference are useful for assessing health risk and
>   should be measured in clinical settings and epidemiologic research whenever
>   possible," the investigators say. But abdominal fat measured by waist
>   circumference "can indicate a strong risk for diabetes whether or not a man
is
>   considered overweight or obese according to his BMI," lead author Dr. Youfa
Wang
>   added in a statement.
>   In the study, investigators compared the predictive power of BMI, waist
>   circumference (WC) and waist-to-hip ratio (WHR) for the development of type
2
>   diabetes in 27,270 men participating in the Health Professionals Follow-up
>   Study.
>   During 13 years of follow up, a total of 884 men developed type 2 diabetes,
>   Dr. Wang, from Johns Hopkins Bloomberg School of Public Health in Baltimore,
>   and  colleagues report in the March issue of the American Journal of
Clinical
>   Nutrition.
>   According to the team, the age-adjusted relative risks across quintiles of
>   WC, starting at a WC of 73.7 to 86.4 cm (29 to 34 inches) and going up to
101.6
>    to 157.5 cm, were 1.0, 2.0, 2.7, 5.0, and 12.0, respectively, they report.
>   For WHR, relative risks across increasing quintiles were 1.0, 2.1, 2.7, 3.6,
>   and 6.9 and for BMI they were 1.0, 1.1, 1.8, 2.9, and 7.9, respectively.
>   "Our findings support the contention that the measurement of WC should be
>   used in clinical practice instead of WHR," the investigators write.
>   The study findings also suggest that the currently recommended cutoff for
>   high waist circumference of 102 cm (40 inches) for men may need to be
lowered to
>    95 cm. "Many of the men who developed type 2 diabetes had measurements
lower
>    than the cutoff, Dr. Wang explained, "and the risk associated with the
waist
>    circumference increased at a much lower level."
>   Am J Clin Nutr 2005;81:555-563.
>
>
>   [This message contained attachments]
>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 7
>      Date: Thu, 31 Mar 2005 23:33:25 EST
>      From: beefymusclebud@a...<mailto:beefymusclebud@a...>
>   Subject: One stop patient assistence, this is important
>
>   Some Free Medicine Programs Too Complex: Survey
>
>   Mar 30 - Drug company programs that offer free medicines to the poor are 
too
>   time-consuming and complex for some health clinics that serve mostly
>   low-income patients, according to a survey released on Tuesday.
>   Of 214 clinics in five states that were surveyed in 2002, forty-eight said
>   they did not participate in patient assistance programs that provide free
>   medicines to people who cannot afford them.
>   More than two thirds of the clinics that did not take part said the programs
>   were cumbersome and took too much time. Some companies required tax returns
>   and  made other unrealistic demands for income documentation, the survey
said.
>   The Pharmaceutical Research and Manufacturers of America, an industry group,
>   has encouraged companies to simplify application forms, spokesman Ken
Johnson
>    said.
>   "Can we do a better job? Yes, and we will," he said.
>   Early next month, the industry will unveil a new program that will provide
>   one-stop access to 275 existing patient assistance programs, Johnson  said.
>   "We are going to make it easier and quicker to obtain information," he said,
>   adding that millions of people already get free or discounted drugs from
>   manufacturers each year.
>   The health-clinic survey found the drug donation programs consumed an
average
>    of 12 hours of pharmacist time, and 99 hours of other staff time, per
month.
>   While clinic staff believed the donated drugs filled an important need, they
>   "don't understand why complicated and changing programs must take so much
>   time  away from patient care," said Kathryn Duke, the study's lead author
and
>   director  for the Medicine for People in Need program of the nonprofit
Public
>   Health  Institute.
>   The study, funded by the philanthropic California Health Care Foundation,
>   will be published in the April 1st edition of the American Journal of
>   Health-System Pharmacy.
>   Charitable programs from GlaxoSmithKline Plc, Novartis AG and
Schering-Plough
>    Corp. were identified as least likely to be used, while others offered by
>   Pfizer  Inc., Bristol-Myers Squibb Co. and Merck & Co. Inc. were used most
>   frequently.
>   GlaxoSmithKline spokeswoman Patricia Seif said the company donated medicines
>   worth $372 million last year to U.S. patients. "We try to make it easy" to
>   participate, she said, adding that many patients get the requested drugs the
>   same  day.
>
>
>   [This message contained attachments]
>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 8
>      Date: Fri, 1 Apr 2005 16:04:34 EST
>      From: PoWeRTX@a...<mailto:PoWeRTX@a...>
>   Subject: Assessing the Relationship Between Fatigue and Mitochondrial
Toxicity in
Patient
>
>
>   Both HIV infection and antiretroviral nucleoside analogues (nucleoside
>   reverse transcriptase inhibitors or NRTIs) are known to affect mitochondrial
DNA
>   content and mitochondrial function. A number of important clinical syndromes
>   observed in HIV-infected persons relate to mitochondrial dysfunction
including
>   lactic acidosis, myopathy, cardiomyopathy, pancreatitis, peripheral
>   neuropathy,  and possibly lipodystrophy. Fatigue, one of the most prevalent
complaints
>   among  persons with HIV infection, may also be the result of mitochondrial
>   toxicity,  though this has not been clearly established.
>   _http://clinicaltrials.gov/ct/show/NCT00106795?order=201_
>  
(http://clinicaltrials.gov/ct/show/NCT00106795?order=201<http://clinicaltrials.g\
ov/
ct/show/NCT00106795?order=201>)
>
>   In  health,
>
>   Nelson Vergel
>   Director
>   Program for Wellness Restoration,  PoWeR
>   A 501 (c) 3 non profit national  organization
>   powerusa.org
>   salvagetherapies.org
>   faciawasting.org
>
>
>   Disclaimer
>
>   This  information (and any accompanying printed material) is not intended to
>   replace  the attention or advice of a physician or other health care
>   professional. Anyone  who wishes to embark on any dietary, drug, exercise,
or other
>   lifestyle change  intended to prevent or treat a specific disease or
condition
>   should first  consult with and seek clearance from a qualified health care
>   professional.
>
>
>   [This message contained attachments]
>
>
>
>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 9
>      Date: Fri, 1 Apr 2005 16:06:48 EST
>      From: PoWeRTX@a...<mailto:PoWeRTX@a...>
>   Subject: MRI to assess facial wasting and AVN
>
>
>
>   This study will examine risk factors for facial wasting and avascular
>   necrosis (AVN, a type of damage to the hip and other bones) in HIV-infected
>   patients. The prevalence and natural history of AVN are also being
evaluated.  This
>   study will use magnetic resonance imaging (MRI) to identify and monitor 
these
>   conditions in patients with and without diagnosed AVN and to identify risk
>   factors.
>   _http://clinicaltrials.gov/ct/show/NCT00001762?order=202_
>  
(http://clinicaltrials.gov/ct/show/NCT00001762?order=202<http://clinicaltrials.g\
ov/
ct/show/NCT00001762?order=202>)
>   In  health,
>
>   Nelson Vergel
>   Director
>   Program for Wellness Restoration,  PoWeR
>   A 501 (c) 3 non profit national  organization
>   powerusa.org
>   salvagetherapies.org
>   faciawasting.org
>
>
>   Disclaimer
>
>   This  information (and any accompanying printed material) is not intended to
>   replace  the attention or advice of a physician or other health care
>   professional. Anyone  who wishes to embark on any dietary, drug, exercise,
or other
>   lifestyle change  intended to prevent or treat a specific disease or
condition
>   should first  consult with and seek clearance from a qualified health care
>   professional.
>
>
>   [This message contained attachments]
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>   ________________________________________________________________________
>   ________________________________________________________________________
>
>   Message: 10
>      Date: Thu, 31 Mar 2005 21:45:31 EST
>      From: PoWeRTX@a...<mailto:PoWeRTX@a...>
>   Subject: HIV Transplant study website
>
>
>   _http://spitfire.emmes.com/study/htr/_
(http://spitfire.emmes.com/study/htr/<http:/
/spitfire.emmes.com/study/htr/>)
>
>
>   In  health,
>
>   Nelson Vergel
>   Director
>   Program for Wellness Restoration,  PoWeR
>   A 501 (c) 3 non profit national  organization
>   powerusa.org
>   salvagetherapies.org
>   faciawasting.org
>
>
>   Disclaimer
>
>   This  information (and any accompanying printed material) is not intended to
>   replace  the attention or advice of a physician or other health care
>   professional. Anyone  who wishes to embark on any dietary, drug, exercise,
or other
>   lifestyle change  intended to prevent or treat a specific disease or
condition
>   should first  consult with and seek clearance from a qualified health care
>   professional.
>
>
>   [This message contained attachments]
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>
>   Nelson Vergel (PoWeRTX@a...<mailto:PoWeRTX@a...>)
>   List Founder and Moderator
>
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In health,

Nelson Vergel
Director
Program for Wellness Restoration, PoWeR
A 501 (c) 3 non profit national organization
powerusa.org
salvagetherapies.org
faciawasting.org


Disclaimer

This information (and any accompanying printed material) is not intended to replace the attention or advice of a physician or other health care professional. Anyone who wishes to embark on any dietary, drug, exercise, or other lifestyle change intended to prevent or treat a specific disease or condition should first consult with and seek clearance from a qualified health care professional.

Welcome to our PozHealth group!
If you received this email from someone who forwarded it to you and would like to join this group, send a blank email to PozHealth-subscribe@yahoogroups.com and you will get an email with instructions to follow. You can chose to receive single emails or a daily digest (collection of emails). You can post pictures, images, attach files and search by keyword old postings in the group.

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NOTE: I moderate, approve or disapprove emails before they are posted. Please follow the guidelines shown in the homepage. I will not allow rudeness, sexually  explicit material, attacks, and anyone who does not follow the rules. If you are not OK with this, please do not join the group.

Forward this email to anyone who may benefit from this information! Thanks!
In Health,

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It would be useful to contact the authors.  In general, anabolic
steroid use is much less in HIV patient in France, as the government is
much tighter in controlling use of these agents.

I believe they are talking about cortico steroids, but this needs to be
clarified.  The authors and journal editors should be strongly
reprimanded for their carelessness.

JB
On Apr 2, 2005, at 1:32 PM, PozHealth@yahoogroups.com wrote:

> This comparative analysis investigating a wide range of factors
> revealed that
> current alcohol use and a history of steroid use were strongly
> associated
> with the occurrence of AN.

Whoever persists in writing "steroid" use, in a medical article is a
fucking moron.  What drugs are we talking about?  Corticosteroids for
inflammation and asthma?  Anabolic steroids for muscle building?  Isn't
this supposed to be a medical journal?

I am sick and tired of people who should know better using imprecise,
contradictory, and confusing terminology.    This is a question of
great community interest, and to use such idiotic verbage borders on
criminal.

My understanding remains that cortico-steroids are the problem. This
citation does a great job of muddying the waters, and it is uncalled
for.

JB
On Apr 2, 2005, at 1:32 PM, PozHealth@yahoogroups.com wrote:

> Steroid use and alcohol abuse are the most common risk factors
> associated
> with AN [26]. Indeed, in the present study, a history of steroid use
> was
> independently associated with a high risk of AN, and the association
> did persist when
> the analysis was adjusted for other variables.

This is all VERY INTERESTING.  I tried Sustiva and
couldn't stand it.  My doctor then tried Abacavir, and
I told him I still felt "messed up," so we stopped
that as well.  This was all a few years ago.
At the time, my doctor told me that Abacavir wasn't
known to have such side effects.  I felt very
disoriented on the stuff.  Thanks Nelson for posting
all of this on Abacavir - it feels like a mystery has
been solved (and I feel slightly vindicated).  These
meds really can have a range of side effects for
diffent people. OH well ...


--- PoWeRTX@... wrote:

> This happened  to me also. I know several  people
> that have had the same
> problem on Ziagen. Doctors and patients do not  know
> about this.
> More on abacavir-induced neuropsychiatric reactions.
>
> Foster R, Taylor C, Everall IP.
> AIDS. 2004 Dec 3;18(18):2449.
> It is increasingly recognized that  antiretroviral
> medications may induce
> severe, but transient, changes in mental  state.
> These are uncommon and
> idiosyncratic, with the literature containing only
> two published reports suggesting
> that abacavir (Ziagen), a nucleoside reverse
> transcriptase inhibitor, may
> induce a range of neuropsychiatric disorders in
> seropositive individuals. These
> include depression, suicidal thoughts, auditory
> hallucinations [_1_
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?QS2=434f\
4e1a73d37e
>
8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d35fcac6cd23743905e8d6761
>
84e808855bd7f415e7acd48b9da8092db6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6
> #17) ]  and frank psychosis [_2_
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?QS2=434f\
4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d154
>
97b83b9e5baab68f6262d35fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da8092db
> 6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6#18) ].
>  Of note is the fact
> that the subjects in these cases were all female
> with CD4  cell counts below 500
> cells/µl. Here we report, for the first time, a
> case of a  possible
> abacavir-induced neuropsychiatric reaction in a
> seropositive Caucasian  man with a
> higher CD4 cell count.
> The patient was a 44-year-old gay man who was
> diagnosed HIV positive in
> 1993. He was referred to psychiatric services in
> 2000  after the psychologist whom
> he had been seeing became concerned about the
> patient's ongoing depressive
> symptoms. He had previously been treated with
> various antidepressants and
> triple therapies for HIV, and was currently
> receiving citalopram 30 mg a day in
> addition to tenofovir 245 mg per day,  nevirapine
> 200 mg twice a day and
> abacavir 300 mg twice a day. He had previously  been
> taking didanosine, but this was
> changed to abacavir because of  lipodystrophy.
> Approximately one week after commencing  abacavir,
> the patient started to
> complain of feeling tired and ‘stoned'. He also
> complained of headaches, which
> were described as ‘constant and throbbing’ and
> ‘located in the middle of my
> brain'. He reported the onset of bad dreams, which
> he referred to as ‘night
> terrors'. These were described as vivid and
> terrifying,  but the actual content
> could not be recalled. He denied any associated
> physical  symptoms such as
> night sweats or any recent physical illness. His CD4
> cell count  at this time was
> 557 cells/µl and his viral load was less than 50
> copies/ml. Of  note is the
> fact that despite his dreams he now felt that his
> previously low  mood had
> improved to the extent that he was expressing the
> desire to cease  taking
> citalopram.
> Two weeks after reporting the above problems,  the
> patient was reviewed by
> the HIV physician who changed the abacavir back to
> didanosine. Within 24 h of
> this the patient reported that his headaches and bad
>  dreams had stopped, and
> that he was feeling less fatigued. At one month
> follow-up he remained free of
> these symptoms, and his mood remained settled. The
> citalopram was eventually
> reduced gradually and finally stopped.
> This case suggests that abacavir may, in rare
> cases, induce unpleasant but
> non-specific neuropsychiatric side-effects, which
> can resolve rapidly upon
> stopping this medication. Although it has been
> suggested that abacavir may be
> associated with new-onset depression [_1_
> (http://gateway.ut.ovid.com.ezproxyhost.library.
>
tmc.edu/gw2/ovidweb.cgi?QS2=434f4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83\
b9e5baab68f6262d35fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da
>
8092db6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6#17)
> ],  this was not
> apparent in the current case. In that earlier
> publication [_1_
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?QS2=434f\
4e1a73d37e8c8a96d3
>
ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d35fcac6cd23743905e8d676184e80885
>
5bd7f415e7acd48b9da8092db6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6#17)
> ],
>  depression and night sweats were reported in one
> patient, with depression,
> suicidal ideation, headache, auditory hallucinations
> and anorexia in the
> second.  The patients in those cases were both HIV
> positive Caucasian women.
> Similarly, a  more recent publication described a
> case of putative abacavir-induced
> psychosis  occurring in an African woman [_2_
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?QS2=434f\
4e1a73d37e8c8a96d3ba1aa0ba0d5b5
>
3d5e5632d15497b83b9e5baab68f6262d35fcac6cd23743905e8d676184e808855bd7f415e7acd
>
48b9da8092db6e57b008cbb2cb6d164cd511242a35a0302af534fa8b6#18)
> ]  who became
> symptom-free after the cessation and substitution of
> this  medication.
> The current report suggests that men can also  be
> adversely affected by
> abacavir-associated neuropsychiatric problems, even
> at  a higher CD4 cell count
> accompanied by a low viral load. Furthermore,
> symptoms  may rapidly resolve upon
> discontinuation of abacavir and the substitution of
> a  suitable alternative
> antiretroviral agent. It is possible that headache
> and mood  alterations may be
> early indicators of neuropsychiatric sequelae
> associated with  abacavir. These
> should be investigated and monitored closely to
> exclude possible  organic
> factors. Management should be carried out in
> collaboration with both HIV
> physicians and specialist psychiatrists.
> References
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?QS2=434f\
4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d3
>
5fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da8092db6e57b008cbb2cb6d164cd5
> 11242a35a0302af534fa8b6#toc)
> 1. Colebunders R, Hilbrands R, De Roo A, Pelgrom J.
> Neuropsychiatric reaction
> induced by abacavir.  Am J Med 2002; 113:616.
> _ExternalResolverBasic_
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?Link+Set\
+Ref=0
>
0002030-200412030-00021|00000439_2002_113_616_colebunders_neuropsychiatric_|00
>
002030-200412030-00021#xpointer(id(R1-21))|1103920|http://acs.ovid.com/acs/.f6
>
489bf4937db0b6e5a4e52b4a0f690866ea468998ca8e6ac6e6d949d499ba8ceb07ec98d2542738
>
eb60d9d5afd443af26842fbd2b397e36e9ea7cf26a19744cf8bf2cf6fefeecf6eb.gif|ovftdb|
>
00000439-200211000-00018&P=17&S=IDNJHKJKBAMCKK00D&WebLinkReturn=Full+Text=L|S.
> sh.15.16|0|00002030-200412030-00021)
> _Bibliographic  Links_
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?Link+Set\
+Ref=00002030-
>
200412030-00021|00000439_2002_113_616_colebunders_neuropsychiatric_|00002030-2
>
00412030-00021#xpointer(id(R1-21))|60|http://acs.ovid.com/acs/.6f8cf7c31ada011
>
97afb0a1ba3d293b287b71168019f9ea6ec0cdc7f51235e3420b469cc1e8a8406f3c6be4f14376
>
dfd09416d1f878f23bb78.gif|ovftdb|00000439-200211000-00018&P=17&S=IDNJHKJKBAMCK
>
K00D&WebLinkReturn=Full+Text=L|S.sh.15.16|0|00002030-200412030-00021)
>
> _[Context  Link]_
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?QS2=434f\
4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f6262d3
>
5fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da8092db6e57b008cbb2cb6d164cd5
> 11242a35a0302af534fa8b6#10)
> 2. Foster R, Olajide D, Everall IP. Antiretroviral
> therapy-induced psychosis:
> case report and brief  review of the literature. HIV
> Med  2003; 4:139–144.
> _[Context  Link]_
>
(http://gateway.ut.ovid.com.ezproxyhost.library.tmc.edu/gw2/ovidweb.cgi?QS2=434f\
4e1a73d37e8c8a96d3ba1aa0ba0d5b53d5e5632d15497b83b9e5baab68f62
>
62d35fcac6cd23743905e8d676184e808855bd7f415e7acd48b9da8092db6e57b008cbb2cb6d16
> 4cd511242a35a0302af534fa8b6#10) Accession Number:
> 00002030-200412030-00021
>
> In  health,
>
> Nelson Vergel
> Director
> Program for Wellness Restoration,  PoWeR
> A 501 (c) 3 non profit national  organization
> powerusa.org
> salvagetherapies.org
> faciawasting.org
>
>
> Disclaimer
>
> This  information (and any accompanying printed
> material) is not intended to
> replace  the attention or advice of a physician or
> other health care
> professional. Anyone  who wishes to embark on any
> dietary, drug, exercise, or other
> lifestyle change  intended to prevent or treat a
> specific disease or condition
> should first  consult with and seek clearance from a
> qualified health care
> professional.
>


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