Forum on Aging With HIV

How to find an HIV specialist

Sat, 19 Aug 2017 16:50:24 -0400

Q: I just recently retired after 40 years in the same profession. I live in Los Angeles and due to the cost of living, I may be moving to another state where I have family and the the cost of living is less. My question is, how can I find a good HIV specialist. Is there a website or other resource that could help me find a new doctor in my future states/city? Any resource you can share will be greatly appreciated. Thank you for all you do.

A: You can use this search engine as part of the American Academy of HIV Physicians.Also, call the main HIV non-profits in your new city and ask them who they think are best. Academy of HIV Physicians Referral Page Of course, check with the doctor(s) to find out if they take your insurance.Good luckRegards,Nelson Vergel

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PRO 140 UPDATES?

Sat, 19 Aug 2017 16:46:22 -0400

Q: What's the latest on the injectable that Charlie Sheen is bragging about in Variety? http://variety.com/2017/biz/news/charlie-sheen-hiv-diagnosis-cytodyn-1202410440/

A: Cytodyn is enrolling two studies right now using their once per week CCR5 inhibitor injection.One of the studies is looking for patients who have a viral load and who have HIV that has developed resistance to 3 drug classes. They will start PRO-140 plus two new medications to which their virus is susceptible. Patients have to have a R5 tropic virus.The other study is looking for people who patients with undetectable viral load who want to stop their daily oral medications to switch to their wee...

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Hateful Hump

Sat, 01 Jul 2017 18:36:34 -0400

Q: I have felt with this "buffalo hump" for years, first noticed in 1997. I where hoodies 24/7, even in the summer heat. I've become very reclusive for years. Are there any new medz (tried egrifta) or treatments to erase this thing from my body?? I just can't function outside of my comfort zone. I've even met with several plastic surgeons, $6000 to fix but still could come back. Also sonabella, but they say the same. Frustrated as hell. Thoughts?Thx for your time,Marc

A: Hello and thanks for posting. There are no medications that have been proven to reduce a buffalo hump. Liposuction works, but is expensive as you have found. I have treated a few patients with Cool Sculpting with positive results. There has been a very gradual reduction of the fat pad after multiple treatments. The cost? When one adds up the cost of Cool Sculpting it would be around $600 per session and might take 5 sessions about 2 months apart for really meaningful results. Would these result...

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Visceral Gut Persistence

Thu, 22 Jun 2017 23:23:08 -0400

Q: Hey Nelson,I have read your responses to questions similar to mine, hoping you might have suggestions. I'm 64, poz 20 years. Lab numbers aok until this last year. A1c jumped to 6.3, diabetes runs in family, and that really was a wake up call. I had blown off the gym 5 years ago, motivation issues. I had added 17 lbs since then, btw I'm 6.1, normal weight 195, I hare gene back to working out, weights and or cardio 6 days. A1C back in line in three months time. Got a gut though, ifluctua...

A: Hello Paul:Since I get questions like yours frequently, I have summarized information in this post: How to deal HIV-related fat accumuation Please let me know if you have any questions after you read that information. It seems a lot of digest but, as you know, decreasing visceral fat is not an easy task!In health,Nelson

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ADAP asset test

Sat, 20 May 2017 16:34:01 -0400

Q: Hi,I am considering moving from unaffordable California to another state. As an individual with HIV, of course I'm going to look at ADAP eligibility in other states. As far as I was aware, the only concern I had was how many multiples of the Federal Poverty Level other states had for ADAP eligibility. I was rather shocked that several places had asset tests, including New York, Delaware, D.C and a few other mostly liberal places. I have never heard of asset tests when it came to ADAP and ac...

A: Thanks for your question. ADAP (AIDS Drug Assistance Programs) provide vital funding for HIV medication for thousands of individuals across the county. ADAP funding comes from HRSA, the federal Health Resources and Services Administration. Funding is provided directly to states, and each state has the ability to determine their own eligibility criteria.Thirteen states include an asset test to determine eligibility, and fourteen include the income of a domestic partner in the income calculations....

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Bone density/Heart issues when HIV+ but undetectable viral load

Tue, 09 May 2017 17:54:46 -0400

Q: I keep reading that people with HIV+ are more prone to bone density issues, as well as heart issues (I am currently having issues with both - severe pain in my hips and heart palpitations). My question is: if a person adheres to their drug regimen, and continues to have an undetectable viral load, are they still prone to bone density issues / heart issues. Is a poz person less prone to issues if their viral load has been undetectable for years? I was on Stribild, but recently switched to Genv...

A: Replicating virus can decrease bone density in HIV positive patients.However, bone density loss can still occur in patients with undetectable HIV viral load. There are 2 reasons why this happens. One is the remaining inflammation that occurs even had low levels of HIV in the blood. The next one is medication-induced bone density loss. Tenofovir , a medication included in Stribild, is well known to cause bone density loss. This drug has been replaced by TAF which seems not to cause this prob...

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Does psycho therapy solve problems with depression and panic attacks?

Fri, 28 Apr 2017 16:34:15 -0400

Q: I'm thinking if it can help me with my depression. thanks

A: Thanks for writing. The very short answer to your question is yes, absolutely.Those of us living with HIV are at a greatly increased risk for both depression and anxiety. Panic attacks, which often feel like a heart attack, can be extremely disturbing. The experience of being diagnosed with HIV and living with HIV, even today when medications control the virus, very often creates severe anxiety and depressive symptoms.Psychotherapy can help by using cognitive behavioral therapy, which helps you ...

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I am broke. Considering moving to a cheaper country. Which ones are OK for HIV+ people?

Wed, 19 Apr 2017 17:32:06 -0400

Q: I am almost 63 years old. Social Security Disability for 10 years. Income $1888./monthI currently live in Southeastern Massachusetts.I can't afford to live here anymore. Massachusetts is great, but one of the programs that helps me with insurance has been cut, and because I live so close to the edge, life here is becoming untenable. I am hitting food pantries and missing medical appointments for lack of gas money. Even though my mortgage is a reasonable $950/month, I will not be able to ...

A: I am sorry about your current financial stress. I am glad you are looking for options to make your money go further.Before you think about moving overseas, explore the area of Fort Lauderdale in Florida since their cost of living is a fraction of what is in Massachusetts. If the cost of living there is still an issue, here are some countries that some of my pozhealth group members suggest:From Chad:"You might look at Thailand. It is fairly inexpensive to live there and medication is significa...

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Sifilis y resistencia antiretroviral

Mon, 17 Apr 2017 17:08:41 -0400

Q: Hola buenas tardes, mi pregunta es la siguiente:Hace un año fui diagnosticado con SIDA. en mis primeros examenes tenia una carga viral de 1.200.000 y un recuento de CD4 de 28, razón por la cual me medicaron inmediatamente. A los tres meses me tomaron otra vez la carga viral, la cual descendió a 244.146, una cifra que desconcerto a mi doctor pues no había bajado ni un log. Me hicieron un examen de genotipo y me cambiaron el TAR a Kaletra con Truvada. A los 3 meses mi carga viral era de 206 y...

A: Es dificil de decir. El sifilis aumenta los chances de infeccion con VIH y tambien puede aumentar la carga viral. Es dificil transmitir otras cepas mientras estes tomando medicamentos del VIH que esten trabajando.Yo me hago examenes de infecciones venereas cada 6 meses por si acaso.Buena suerte.Nelson

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Genvoya and Drug Test

Mon, 17 Apr 2017 17:05:21 -0400

Q: Hello,I recently started taking HIV medication Genvoya, and I am wondering if this will cause a false positive for a drug test (since i have to take one in 2-3 weeks, and afraid that there might be a failure in the drug test Please help. Thank you

A: The answer is no.In health,Nelson

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SSA Benefit

Sun, 26 Mar 2017 16:05:13 -0400

Q: I have been on SSI since 1999 I'm 66 yr old and feel threaten to loose my benefit due to the improvement on HIV meds my health is ok considering the constant battles with the side effects I don't see myself getting back on the work force due to weight problem and focus level is there anything I should be worry about of loosing my beneffits

A: Great question.I have addressed this concern in an article I wrote a while ago:The Long-Term Survivor Dilemma When it comes to protecting your disability benefits, I am going to quote something from Tim Murphy's recent article:"The most important thing to know and do? Be meticulous in documenting all your health issues with your doctor, even if they include things such as neuropathy, fatigue or gastrointestinal problems that ...

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Peripheral Neuropathy

Wed, 22 Mar 2017 15:05:02 -0400

Q: I was diagnosed 6 years ago with and over the past 8 months I have been experiencing sharp stabbing pains burning and billions of pins and needles in my feet. Since July of 2016 dizzying feeling and falling a lot has been happening. Due to insurrunce issues (hospital and drs would not accept) I could not have a emg or see a neurologist till feb and march. I was told by the dr doing the emg with the elctro pads and then needles in my legs and back that I have neuropathy. The neurologist has now...

A: I am so sorry you are experiencing neuropathy. Many factors can contribute to nerve damage that can cause neuropathy pain, including physical injury or trauma, genetic factors, infectious diseases, exposure to toxic substances (e.g., alcohol, drugs, heavy metals, solvents), and metabolic disorders (e.g., thyroid dysfunction, diabetes). But in people with HIV/AIDS, PN is usually due to the effects of the virus itself on nerve cells, immune system activity associated with HIV, nerve damage relat...

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Cuando tomar creatina

Tue, 07 Mar 2017 15:57:07 -0400

Q: Hola Nelson,tengo 54 años, estoy en tratamiento(Trubada, Ritonavir, Atazanavir) desde hace seis años, CV indetectable y los CD4 entre 700/900, trabajo y hago actividad física 5/6 días a la semana ya que hago carreras de trail, hago una alimentación sana y equilibrada, alta en proteínas, estoy tomando un suplemento de vitaminas y mineral y comencé a tomar creatina, por lo que pude leer tiene beneficios para los VIH+, lo que quería saber si la puedo tomar cuando tomo los medicamentos y el ...

A: La creatina aumenta el nivel de creatinina, el cual mide la funcion renal. El aumento no quiere decir que los rinones tienen problemas pero los doctores se confunded expecialmente ya que tu estas tomando tenofovir (parte de Truvada). Tenofovir puede afectar la funcion renal asi que la creatina puede asustar al doctor quien va a pensar que la elevacion de creatinina es debida al tenofovir. Asi que dile al doctor.5 gramos por dia 1 hora antes de hacer ejercicio puede ayudar a fortalecerte y aum...

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How to tell my boyfriend am hiv+

Mon, 06 Mar 2017 18:56:06 -0400

Q: My boyfriend and i have been together for six months.And therefore we are both in a serious relationship. he wants us to build a family but here is the problem ,Is am scared on how to tell him about my case and how is going to react.My question in which process shoild i proceed to tell tell him about my health? What advises would you give?Thank you.

A: I am sorry that you are in this difficult situation.In my opinion, the longer you wait, the higher are the chances for him to feel lied to and probably leave you because of that. But, on the other hand, he may turned out to be understanding after you tell him that you were keeping this from him because you were afraid of rejection.You could tell him that you are terribly sorry and stress the fact that you love him. I am assuming that you have undetectable viral load and that you have not exp...

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Why only one person cured of HIV in ten years?

Sat, 04 Mar 2017 19:57:32 -0400

Q: Nelson, I just saw the news of Timothy Brown's recent 10 year anniversary of being cured of HIV. I am happy for him but sad that noone else has been cured since he was. Why is that? Why can't they repeat his case? Not enough research? Or was he just a miracle?

A: That is a great question that I have heard several times as we get frustrated as time goes by and no one else is cured. Every few weeks we hear of the latest "HIV Cure" in the news and we become jaded as we realize that those headlines are only meant to get more clicks from readers.I summarized here an attempt to answer your question:WHY HAS ONLY ONE PERSON BEEN CURED OF HIV IN 10 YEARS?
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My Dr. Switched my Efavirenz for a Generic brand named Yoanivag

Fri, 10 Feb 2017 21:29:10 -0400

Q: Can I trust the new generic Efavirenz named Yoanivag that my Dr gave me here in Mexico. I was taking until last month Stocrin and I am afraid if it will be bsd for me to change my medication. Can you please advise me Nelson?

A: Yoanivag is efavirenz that Mexico gets cheaper. It is real. Efavirenz genérico In health,Nelson

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Red Yeast Rice Safety in HIV+ People with Normal Cholesterol

Tue, 07 Feb 2017 22:22:35 -0400

Q: Dear Nelson,Thank you for all your enormous help as a knowledgeable long-term survivor. You are a blessing to all of us. There is an ongoing debate and a big-scale study regarding the use of statins in HIV patients, regardless of their cholesterol levels, since statins have anti-inflammatory properties and are thought to lower chronic inflammation in HIV patients.Questions:1. Do you think it is a good idea that someone in his late 40's with normal cholesterol levels and no other cardiovascular r...

A: Reducing normal cholesterol blood levels can decrease hormone production. Cholesterol is the "mother molecule" of sex and adrenal hormones.Red yeast rice is made from rice fermented by Monascus purpureus yeast. It contains chemicals that are similar to prescription statin medications. One of these, called monacolin K, has the same makeup as the drug lovastatin (Mevacor). Doctors prescribe statins to lower LDL ("bad") cholesterol levels and help reduce the risk of heart disease. Most red yeast s...

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Always tired. What can I do?

Tue, 07 Feb 2017 18:10:21 -0400

Q: I'm always tired and fatigued no matter how much or little or sleep i get. I feel ill a lot and run down, I've been starting to get cold when usually I'm not, and very thirsty.

A: I am sorry that you feel tired. I have dealt with this issue since the start of my infection 34 years ago. Fatigue can be caused by many different factors. I suggest that you discuss these ones with your doctor:Active HIV infection. When HIV multiplies rapidly, your body uses a lot of energy trying to fight it. Most people have more energy after they start taking HIV medications to achieve undetectable viral load.Other active infections. Other infections can tire you out, even without obvious ...

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comenzar tratamiento y rash

Mon, 23 Jan 2017 18:45:51 -0400

Q: Buenas me detectaron VIH en 10/2016 con Cd4 226 y CV 41000 sin embargo no recibi tratamiento hasta enero de este año 01/2017 me repitieron los examenes con CD4 522 y CV 59000, me dieron Lamivudina, Efavirenz y Tenofovir y a los 8 dias de comenzar el tratamiento hice rash cutaneo, me dijeron que suspendiera tratamiento con 5 dias de prednisona 60mg x day y cetrizina 10mg x día, mis preguntas son las siguientes: por que mi CD4 aumentaron de octubre a enero en vez de disminuir?; que esquema de tr...

A: No puedes usar Atripla otra vez. Algunos pacientes tienen reacciones cutaneas como la tuya. Ellos son cambiados a regimenes con inhibidores de proteasa o integrasa.Para el VPH hay varios tratamientos: http://www.webconsultas.com/salud-al-dia/vph/tratamiento-de-la-infeccion-por-vph-8911 Dependiendo del tamano y severidad, la decision de usar la mejor opcion es tomada por tu doctor.Esperando que tengas mucha salud,Nelson

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Efavirenz genérico

Mon, 16 Jan 2017 15:43:59 -0400

Q: Hola NelsonTe escribo porque nos recibieron el año nuevo con un efavirenz genérico llamado Yoanivag, del laboratorio mexicano Novag. Hasta el momento había estado tomando Truvada y Stocrin. Mi pregunta es qué tan efectivos son estos medicamentos genéricos. ¿Son igual de efectivos que los no genéricos? Me da miedo que fracase mi tratamiento todo para que el gobierno se ahorre unos pesos. Gracias por tu respuesta

A: Si, efavirenz en Mejico esta registrada baja ese nombre y otras. Son de verdad.Nelson

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HIV & Vaccination & my GP

Fri, 23 Dec 2016 14:42:45 -0400

Q: Hello Nelson,I would like to get all the recommended vaccines for hiv-positive people:- hepatitis A (I have immunity for B); - influenza (flu); - human papillomavirus (HPV) the Gardasil 9-valent one (I'm 31);- pneumococcal (pneumonia);- tetanus, diphtheria, and pertussis (the single vaccine that protects against the three diseases)My CD4 count is 436. However, I would prefer not to reveal my HIV status to my Doctor (General Practitioner). Is there a risk involved in not revealing my status prior...

A: Those vaccines are all considered safe and are recommended for use in appropriate HIV+ persons. KH

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heartattack

Sat, 17 Dec 2016 16:55:18 -0400

Q: I have read reports on the web that HIV infected are MORE likely to have heart attacks, is this true?

A: HIV positive people not on treatment have higher risk of cardiovascular risks due to ongoing infection, inflammation, low HDL cholesterol, and eventual opportunistic illnesses and wasting syndrome. This added risk can be reduced by bringing HIV viral load to undetectable levels. However, patients with undetectable viral load may still have higher cardiovascular risks than HIV negative healthy people if they use HIV medications that increase LDL cholesterol and triglycerides and lower kidney fu...

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CD4 COUNT DECREASE

Fri, 25 Nov 2016 19:14:31 -0400

Q: I was tested positive three months ago and now the doctors keep getting blood samples from me. Yet again am scheduled to go back next week. I'm tired of the injections and my arm feel weak. How will I know for sure when my cd4 count gets below 500. Your quick response would be appreciated

A: Are you receiving immunizations on your arm? Is that what you refer to?There is no way to tell when your CD4 cells are under 500 cells/mm3. Most people do not "feel" different. Are you asking because you cannot get HIV medications in your country unless your cD4 cells are under 500?Please elaborate. I am here to help.Nelson

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Decrease of size of buttocks and private parts

Wed, 02 Nov 2016 21:19:59 -0400

Q: Hi Sir,I am aging with HIV for 9 years and in medication (trustiva (tenofovir disproving fumarate, emtricitabine& efavirenz).1) I have huge buttock loss causing difficulty to sleep due pain when I sleep or sit for long time.2) I am facing numbness in my fore hand 3) My private part size has become very lien(width) and small..( I felt depressed and purchased 'Proextender' for this reason)Could you please kindly advice.Thanking you with regards,Nani K

A: NaniI am sorry that you are experiencing those three issues. I will try to explain possible reasons for each one of them:1- Buttock wasting: Most buttock wasting in the past occurred with regimens containing AZT or D4T (Zerit). The new regimens like yours have only shown to decrease fat under the skin in 18 % of patients. The loss does not be as severe and AZT and D4T's but it may be an issue with thinner patients. For info on buttock wasting, visit:Read More

is hiv curable at early stages?

Wed, 02 Nov 2016 21:11:39 -0400

Q: Hi, I don't know I have hiv infection. If it is positive can it be curable at early stages wich is detected in 10 days? Is there FDA approved scientific method in curing HIV at early stages?

A: Unfortunately, there are no therapies or vaccines yet that can clear HIV in early or late stages.Stay tuned on TheBody.com since we update on HIV cure research monthly.Nelson

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