Fw: Hot Topics at The Body's "Ask the Experts" Forums

---

From: "News at The Body" <update@news.thebody.com>

Date: 06 Mar 2012 15:17:15 -0500

To: <nelsonvergel@yahoo.com>

ReplyTo: "News at The Body" <update@news.thebody.com>

Subject: Hot Topics at The Body's "Ask the Experts" Forums

If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html

March 6, 2012 Visit the Forums "Hot Topics" Library Change/Update Subscription
Living With HIV/AIDS Mixed-Status Couples Insurance, Workplace & Legal Concerns HIV/AIDS & Hepatitis C Treatment Other Health Issues & HIV/AIDS HIV & Hepatitis Transmission LIVING WITH HIV/AIDS  Are You Giving Up on the Cure? I was reading your last response about a functional HIV cure in which you claimed that it would most likely take more than 10 years to develop a cure. Reading your previous responses on the issue you seemed much more optimistic. What happened? Nelson Vergel responds in the "Aging With HIV" forum MIXED-STATUS COUPLES  How Much of a Risk Are We Taking With Unprotected Oral Sex? I'm an HIV-negative man and my girlfriend is HIV positive with a viral load of 200,000 and a CD4 count of 750. Oral sex is very important to both of us. I've performed unprotected oral sex on her multiple times, and vice versa, and we're careful about sores and cuts; we always use condoms for intercourse. I've read literature that says anything from there's no HIV risk with unprotected oral sex to I'm most likely already infected. What do you think? Do you know of any documented cases of someone contracting HIV from oral sex on a female? Shannon R. Southall responds in the "Safe Sex and HIV Prevention" forum INSURANCE, WORKPLACE & LEGAL CONCERNS  How Can I Get Health Coverage Back for My Registered Domestic Partner? I'm a retiree in California and have health coverage through my (former) employer, a large California-based aerospace company. My registered domestic partner has had health coverage for the past five years as my dependent. For 2012 my employer is denying coverage for domestic partners. Any idea why they can now refuse coverage, and what we can do about it? Jacques Chambers, C.L.U., responds in the "Workplace and Insurance Issues" forum  Two Chiropractors Refused to Treat Me: What Can I Do? Two different chiropractors have refused to treat me due to my HIV status, directly stating that they didn't have the proper gloves or facilities to treat "people like me." Are there grounds to sue based on this type of discrimination? What actions can I take? Christa Douaihy, Esq., responds in the "Legal Issues and HIV" forum What's coming down the pipeline in HIV treatment, prevention and care? CROI is the largest annual science meeting in HIV, where researchers and clinicians go to learn the most important lessons and developments in the field. The gathering began this weekend, and TheBodyPRO.com -- TheBody.com's sister site for health professionals -- will be on hand to bring you wide-ranging coverage. Visit our CROI 2012 home page frequently this week for key study summaries and a discussion of conference highlights! HIV/AIDS & HEPATITIS C TREATMENT  What's New With Ibalizumab? I've had very good luck with ibalizumab, the drug in development (TNX-355, formerly known as Tanox). Can you give me an update on what's going on with this drug in 2012? Are there any new developments we should know about? Nelson Vergel responds in the "Nutrition and Exercise" forum  Do Calcium and Magnesium Have a Negative Effect on Isentress? I switched to a regimen of Isentress (raltegravir) and Truvada (tenofovir/FTC) recently and am doing very well on it so far. Every morning I usually drink a glass of milk after taking Isentress. I also take vitamin D and calcium supplements. I heard somewhere that calcium and magnesium can affect the effectiveness of Isentress. Is it true? Should I stop drinking milk when I take Isentress as well? Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum  Another Time Around With Hepatitis C Meds: For How Long Will I Be Treated? I'm a 55-year-old man with hepatitis C genotype 1B (my initial viral load was 3.8 million) and in otherwise good health. I'm currently 20 weeks into triple therapy with Incivek (telaprevir), peginterferon and ribavirin, and my hepatitis C viral load was undetectable at four, eight and 12 weeks. I've been unsuccessful on dual therapy before. What does this mean for the length of my treatment course now? Barbara McGovern, M.D., responds in the "Hepatitis and HIV Coinfection" forum OTHER HEALTH ISSUES & HIV/AIDS  Positive Anal Pap Smear but Negative HRA: What's Going On? I've been HIV positive for four years, with a CD4 count of 330 and an undetectable viral load for the past three and a half years. Recently I had a high-resolution anoscopy (HRA) and the examination didn't show any abnormalities, so I was relieved at that. However, my anal Pap smear result showed anal intraepithelial neoplasia (AIN 2). Should I be worried about precancerous changes in my anal canal? How do you interpret these results? If I have HPV (human papillomavirus), how long would it take an HIV-positive person like me to get rid of it? Nelson Vergel responds in the "Aging With HIV" forum  How Do I Know if I'm Depressed? I take Isentress (raltegravir), Selzentry (maraviroc, Celsentri) and Viramune (nevirapine). I've been HIV positive for 22 years and I'm doing well. However, lately I've been losing my drive to exercise and eat well, as I have for the past several decades. I still go dancing every weekend and have a great group of friends, but being single and keeping healthy just for myself is getting hard at age 63. Is this the state of mind the younger generation calls depression? Could it be a side effect of HIV meds? Do you think I'd take better care of myself if I were in a relationship? David Fawcett, Ph.D., L.C.S.W., responds in the "Mental Health and HIV" forum Pen Pal for a Poz Friend in Prison? (A recent post from the "Living With HIV" board) A friend of mine is HIV positive and has been in prison for the past 27 years for a crime he didn't commit. Recently the Innocence Project has taken his case and they have hopes of having my friend released. He became HIV positive while being held in protective custody in 1985. I am hoping to connect him with someone who would like to be a pen pal / friend to him and answer some of his questions about living with HIV. Would anyone out there be interested in contacting him? -- DawnW Click here to join this discussion, or to start your own! To do this, you'll need to register with TheBody.com's bulletin boards if you're a new user. Registration is quick and anonymous (all you need is an e-mail address) -- click here to get started! HIV & HEPATITIS TRANSMISSION  Can a Person With Hepatitis C Donate Organs? Could someone living with hepatitis C (hep C) donate their organs (besides their liver) to others in general? Could they give organs to other people living with hep C? Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum  Why Was I Tested for HIV? I just officially found out I'm pregnant. I already took a preliminary, preconception HIV test six months ago and it came back negative, but I was sent out for another test today. Why would they do this, since my husband and I are completely monogamous with each other and have participated in no other risky behavior since my last test? Is it possible that the first test was a false negative or was not done correctly? Do I need to be concerned? Shannon R. Southall responds in the "Safe Sex and HIV Prevention" forum Worried Your Spam Filter Might Trash Our Mailings? The Body's e-mail updates are especially prone to being caught up in spam filters, since our newsletters tend to refer frequently to sex, drugs, the human anatomy and so forth. To make sure you never miss one of our mailings because anti-spam software labeled it as junk mail, add update@news.thebody.com to your address book, talk to the person who manages your e-mail security or check your anti-spam program's instructions for more information. About This E-mail This e-mail update has been sent to nelsonvergel@yahoo.com. Want to change your subscription? Click here or send us a message at updates@thebody.com. Missed an update? Our archive of past updates will keep you in the loop. Have any other questions or comments, and don't want to send an e-mail? Feel free to snail-mail us at: The Body's E-Mail Updates Remedy Health Media, LLC 250 West 57th Street New York, NY 10107	Tell Gilead to Reduce the Cost of HIV Medications Now!  Under Attack: Your Health Care Rights  Ohioans Living With HIV/AIDS Need Our Help!  Activists Launch New Survey to Help Speed HIV Cure Research  Demand Hershey Reverse Decision on HIV+ Student and Dismiss School Officials  Count HIV+ Women In! PWN Launches National Campaign on World AIDS Day

HIV Reservoirs and Cure Research Lecture at CROI 2012

The first presentation in this link shows Dr John Mellors speaking at the Conference of Retroviruses and Opportunistic Infections in Seattle on March  5, 2012.  He did a great job at an overview of where we are in HIV Cure Research.

HIV Reservoirs and Cure Research Lecture

ViiV Announces Expanded Access of New Integrase Inhibitor...But Activists Are Concerned About Its Potential Misuse

The dolutegravir expanded access program (EAP) has been designed to provide free access to Shionogi-ViiV Healthcare’s investigational integrase inhibitor, dolutegravir (DTG, S/GSK1349572) in an open-label protocol program to adults living with HIV who have documented raltegravir or elvitegravir resistance, who have limited treatment options, and who require DTG to construct a viable antiretroviral regimen for therapy. The dose is 50 mg twice a day for patients with multi drug resistance (the drug will also be eventually approved for once daily use for treatment naive patients)

But before you consider the use of this new drug, read the following warning: Activists Advise Caution About Access Program

Who can participate in the dolutegravir EAP (ING114916)?

The dolutegravir EAP is available to adults living with HIV who (Note: Not all inclusion criteria are listed):

• Are male or female age 18 years or older (female patients of child-bearing potential should use every precaution to prevent pregnancy)
• Have documented plasma HIV-1 RNA levels ≥400 copies/mL within 3 months prior to the screening visit
• Have documented raltegravir or elvitegravir resistance
• Are unable to construct a viable background regimen of anti-retroviral therapy with commercially available medications.

The dolutegravir EAP is not available to adults living with HIV who (Note: Not all exclusion criteria are listed):

• Have estimated creatinine clearance (CrCl) <30 mL/min
• Are pregnant or breastfeeding
• Have had a known or suspected allergic reaction to an integrase inhibitor
• Have an alanine aminotransferase (ALT) level >5 times the upper limit of normal (ULN)
• Have an ALT >3 times ULN and total bilirubin >1.5 times ULN
• Have evidence of severe hepatic impairment
• Are eligible for, and have access to, an actively enrolling DTG Phase III clinical trial
• Have any condition (including but not limited to alcohol and drug use) or any active clinically significant disease or findings during screening of medical history or physical examination, which, in the opinion of the treating physician would interfere with safety or compliance
• Requires or is anticipated to require any of the prohibited concomitant therapy.

*Please note: country specific criteria may also apply.

The dolutegravir EAP is now open and accepting participants in the USA and Canada.

For Europe and the International region, it's expected that the EAP will start to open in March/April 2012 as local regulatory and ethics approvals are obtained.

How to apply for participation

For adults living with HIV: Please discuss your possible participation with your healthcare professional. If the EAP is available in your country, check with your healthcare provider if he or she is a participating site. If not, your healthcare provider may contact PAREXEL for further details on how to access the program.

For healthcare professionals treating HIV: If you have an eligible patient(s), please contact PAREXEL at dolutegravir-eap@parexel.com for further details about the program.

What is dolutegravir?

Dolutegravir (DTG, GSK1349572) is an integrase inhibitor under development as a treatment for HIV-1 infection. Phase III studies to assess the safety and efficacy of dolutegravir in antiretroviral naïve and experienced adults living with HIV are currently underway. The safety and efficacy of dolutegravir has not yet been fully established or thoroughly evaluated by regulatory agencies.

Activists Caution HIV+ Patients and their Physicians About Monotherapy in Upcoming Access Program

FOR IMMEDIATE RELEASE: February 9, 2012

Contact: Nelson Vergel (NelsonVergel@yahoo.com)

Activists Caution HIV+ Patients and their Physicians About

Monotherapy in Upcoming Access Program

New York, February 9, 2012—AIDS activists and physician advocates welcome the news that ViiV Healthcare will be providing  expanded access of dolutegravir (DTG), a new investigational integrase inhibitor for HIV patients with few remaining HIV treatment options.  However, they warn patients and physicians to avoid functional monotherapy, or the introduction of dolutegravir as an "add-on" to a failing treatment regimen if the patient’s virus is resistant to all other currently available antiretroviral drugs (ARVs).  Functional monotherapy has been shown to permit rapid HIV resistance to new medications, which can result in more rapid disease progression, health deterioration, and death.

Currently, the U.S. Department of Health and Human Services (DHHS) adult HIV treatment guidelines recommend three ARVs be given in combination to suppress HIV.  But many patients have HIV that has mutated rendering their virus multi-drug resistant (MDR-HIV).  Those with MDR-HIV cannot construct a viable HIV suppressive regimen with current FDA-approved and commercially available ARVs.  "The DHHS guidelines specify that patients that have developed HIV drug resistance to all commercially available antiretrovirals require access to at least two new active drugs to maximize their chances for treatment response.  However, “another new drug to combine with dolutegravir will not be commercially available for at least two years, and some patients cannot wait that long,” said Nelson Vergel, an activist founder of SalvageTherapies.org.  "For them, access to another research drug in combination with DTG is the only hope for survival," added Vergel.

In studies to date, dolutegravir (DTG) appears to be the most potent integrase inhibitor soon to enter the ARV market.  Unlike Gilead's upcoming elvitegravir, DTG has been shown to be effective against HIV that has developed resistance to Merck's Isentress (raltegravir), the only FDA-approved integrase inhibitor currently on the market.

Fortunately, another new ARV that can help patients with MDR-HIV is in active development and clinical trials.  Ibalizumab, a monoclonal antibody from a small biotech firm, Taimed Biologics, may soon be available via patient participation in research studies.  While ibalizumab has yet to enter phase three studies, it can also be provided to patients at risk of death via a named (or single) patient access application permitted by the FDA via a physician’s direct request to Taimed.  However, it is for the company to approve such requests for compassionate access.

There are no documented estimates of how many people have MDR-HIV in the United States.  A report in the Journal of Clinical Infectious Diseases estimates that about 260,000 patients are being treated with HIV in the United States.  However, it is virtually impossible to know how many are now without sufficient treatment options since no registry for such patients exists.  But most experts agree that this population is probably small – possibly up to 10% of the total in treatment.

"With little immune function left and resistance to all approved HIV medications, I have tried desperately to get access to two new drugs to help save my life,” said Christopher Cacioppo, a patient with MDR-HIV in  San Diego who believes he is running out of time. “My doctor tells me that I have little choice but to wait for the dolutegravir expanded access program and some as yet unknown and unavailable second new drug."

A coalition of activists and physicians have been in discussions with Taimed and ViiV for nearly two years to obtain compassionate-use access to their new ARVs in combination for those with MDR-HIV in greatest need of new treatment options.  The AIDS Community Research Initiative of America (ACRIA), a New York City-based community research and education organization, and physicians in San Francisco have proposed solutions to overcome this “two-drug access barrier” in an effort to secure urgent access to patients across the country.

Physicians and providers with patients with MDR-HIV in need of two new ARVs are urged to complete this form.

###

Fw: Hot Topics at The Body's "Ask the Experts" Forums

---

From: "News at The Body" <update@news.thebody.com>

Date: 07 Feb 2012 18:23:47 -0500

To: <nelsonvergel@yahoo.com>

ReplyTo: "News at The Body" <update@news.thebody.com>

Subject: Hot Topics at The Body's "Ask the Experts" Forums

If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html

February 7, 2012 Visit the Forums "Hot Topics" Library Change/Update Subscription
Living With HIV/AIDS Body Shape Changes & HIV/AIDS HIV/AIDS Treatment Other Health Issues & HIV/AIDS HIV Transmission Strange but True LIVING WITH HIV/AIDS  How Do I Deal With the Uncertainty of Living With HIV? I've found it stressful to see people who are being successfully treated for HIV die between 50 and 60 years old. I just turned 48. What if my number is up in the next decade? Suppose I spend all my money doing things I want to do now, then live into retirement and have nothing saved because I didn't expect to live that long? What if I save lots of money, then die before I'm able to use it? How am I supposed to enjoy my life day by day? David Fawcett, Ph.D., L.C.S.W., responds in the "Mental Health and HIV" forum  Returning to Work: How Will I Keep Paying for My HIV Care? Ever since being placed on Social Security Disability Insurance (SSDI) due to an AIDS diagnosis in 2008, all I could think about was returning to the workforce and finding my place in the community again. However, I'm terrified of losing my ability to pay for my HIV meds and medical care. What do I need to be aware of as I prepare to return to work? Jacques Chambers, C.L.U., responds in the "Workplace and Insurance Issues" forum BODY SHAPE CHANGES & HIV/AIDS  Should I Treat My Enlarged Parotid Glands? I've been looking for information on electron radiation therapy for the treatment of enlarged parotid glands, which can cause facial distortion -- particularly a "moon face" look. Does this treatment method have any clinical benefit besides improving quality of life through cosmetic benefits? Does it have any effect on viral load or CD4 count? Where can I get more information? Nelson Vergel responds in the "Nutrition and Exercise" forum Today, Feb. 7, is National Black HIV/AIDS Awareness Day in the U.S. In observance of the day, TheBody.com asked African-American HIV/AIDS experts to cut through the hype and tell us in plain language what factors are really to blame for the persistence of HIV in African-American communities. HIV/AIDS TREATMENT  What Can I Do if I Can't Get ADAP Coverage? What will happen to people who can't get access to their HIV meds through AIDS Drug Assistance Programs (ADAPs)? If income requirements for eligibility keep lowering, do people have to just not get their meds and wait to die? What are our options? Nelson Vergel responds in the "Nutrition and Exercise" forum  Why Would I Ever Need to Switch Meds? Thankfully, I've never experienced any side effects in the past two years I've been taking Atripla (efavirenz/tenofovir/FTC), my first and only HIV med regimen. Is there a chance that I may one day need to change my medication? What factors would contribute to this need to switch? Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum  How Can I Get Rid of Loose Stools? In my first month on HIV meds I had no side effects, except for slightly looser stools. Now, after several months, it seems my stools are always loose, regardless of what l eat. Is this common? What can I do about it? Keith Henry, M.D., responds in the "Managing Side Effects of HIV Treatment" forum More Questions About HIV/AIDS Treatment: Is Atripla or Triomune Better for Starting Treatment? Will Over the-Counter Sleeping Pills Interact With My HIV Meds? OTHER HEALTH ISSUES & HIV/AIDS  Is Depression in Poz People Caused by the Virus Itself? I recently saw the psychiatrist at my provider's office due to some depressive thoughts. Is depression a common occurrence due to the virus's effect on the body, as opposed to the psychosocial factors that contribute to depression in people living with HIV? Aren't antidepressants just an aid until one can change the psychosocial factors and feel better on their own? David Fawcett, Ph.D., L.C.S.W., responds in the "Mental Health and HIV" forum  Can HIV Meds Slow the Progression of Hepatitis C? How can HIV meds have an effect on hepatitis C virus progression? I've read that they can exacerbate liver damage, but is it possible that the meds could also slow liver disease progression? Barbara McGovern, M.D., responds in the "Hepatitis and HIV Coinfection" forum  Reactive Syphilis Test After Treatment: Is This Possible? Is it possible to be treated successfully for syphilis and have a nonreactive test result, then have another reactive test without having had sex with anybody? Mark Holodniy, M.D., F.A.C.P., C.I.C., responds in the "Understanding Your Labs" forum Hey, Poz LGBT Folks: Share Your Coming-Out Stories! (A recent post from the "Gay Men" board) What has the whole "coming out" process been like as a person living with HIV who is gay, bi or transgender? Is coming out -- as HIV positive and/or as LGBT -- something you still struggle with? Why, or why not? I am a young person in my early 20s. I was born with HIV and I am bi, and I would love to hear other people's stories of coming out! -- Keya Click here to join this discussion, or to start your own! To do this, you'll need to register with TheBody.com's bulletin boards if you're a new user. Registration is quick and anonymous (all you need is an e-mail address) -- click here to get started! HIV TRANSMISSION  Just How Delayed Was the Most Delayed Seroconversion Ever? I had a low-risk exposure to HIV 18 months back. I have tested negative for HIV every three months since that encounter. I've been reading about delayed seroconversion and I was wondering: According to available literature, what is the longest possible duration between HIV exposure and seroconversion? I read about a case in a 1997 study in which seroconversion took eight to nine months. Is that the maximum? David Wohl, M.D., responds in the "Safe Sex and HIV Prevention" forum  Pregnancy Has Me Anxious: Is My Risk Real? I have a fear of contracting HIV from means that are out of my control. I'm pregnant with my fourth baby, and my fears seem to heighten when I'm pregnant. I recently went for prenatal testing and they needed to draw blood. I'm worried that when I wasn't looking, the technician might have accidently pricked herself with the needle she then used to draw my blood. If I contracted HIV or hepatitis C, this would not only affect me but also the baby inside me. I'm really scared and would just like to enjoy my pregnancy rather than worry. Should I get tested for HIV? Lisa B. Hightow-Weidman, M.D., M.P.H., responds in the "Safe Sex and HIV Prevention" forum STRANGE BUT TRUE  Could Sparky's Claws Double as HIV Transmitters? Last week I visited an HIV-positive friend. I brought my small dog that likes to scratch people's legs as a greeting. He scratched my friend's leg, and a few minutes later the dog scratched my arm. Neither of us bled, but my skin did burn and get red. I know the "H" in HIV stands for "human" and dogs cannot contract it, but could the (hypothetical) blood on the dog's nail be fresh enough to have infected me? Richard Cordova responds in the "Safe Sex and HIV Prevention" forum Worried Your Spam Filter Might Trash Our Mailings? The Body's e-mail updates are especially prone to being caught up in spam filters, since our newsletters tend to refer frequently to sex, drugs, the human anatomy and so forth. To make sure you never miss one of our mailings because anti-spam software labeled it as junk mail, add update@news.thebody.com to your address book, talk to the person who manages your e-mail security or check your anti-spam program's instructions for more information. About This E-mail This e-mail update has been sent to nelsonvergel@yahoo.com. Want to change your subscription? Click here or send us a message at updates@thebody.com. Missed an update? Our archive of past updates will keep you in the loop. Have any other questions or comments, and don't want to send an e-mail? Feel free to snail-mail us at: The Body's E-Mail Updates Remedy Health Media, LLC 250 West 57th Street New York, NY 10107	Advertisement  "Update Your Status" This Valentine's Day and Encourage More HIV Testing  Young AIDS Activists! Apply for C2EA's 2012 Youth Action Institute -- June 10 - 16, 2012  Ohioans Living With HIV/AIDS Need Our Help!  Activists Launch New Survey to Help Speed HIV Cure Research  Demand Hershey Reverse Decision on HIV+ Student and Dismiss School Officials  Count HIV+ Women In! PWN Launches National Campaign on World AIDS Day  African American HIV University Community Mobilization College: Apply Today!

What to do if you think you have recently been exposed to HIV

This would definitely be the HIV medication combo that I would take if I was HIV negative and wanted to treat a potential HIV exposure (condom breakage, needle stick, etc). Prior studies were done using Truvada alone (two drugs combined in one pill), but adding raltegravir to Truvada makes a lot of sense. Raltegravir (brand name Isentress) is the HIV medication that lowers HIV viral load the fastest, which is something you need if you have been exposed in the last few hours. It also happens to be a very well tolerated medication.

Note: If you get exposed to HIV, you need to treat quickly (within 72 hours), and then stay on treatment for 4-8 weeks

But a one month supply of Isentress plus Truvada would cost more than $1000. Some people call local HIV doctors or health clinics to find out who has extra medications, or just pay for the medications themselves since insurance companies do not pay for post exposure prophyplaxis treatment. And that is where the dilemma lies..

Here is a small study using the Isentress+ Truvada combo for post exposure prophylaxis :
http://www.aidsmap.com/page/2227321/

Note: If the person that may have exposed you to HIV is on treatment and has undetectable viral load in their blood, the chances of infection are minimized.  So if you can ask that person about their lab numbers, that would provide additional information for your doctor to make a decision.

For HIV doctors around the United States: Directory of HIV Physicians