Tuesday, October 05, 2010

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


Sent via Blackberry


From: "News at The Body" <update@news.thebody.com>
Date: 05 Oct 2010 12:17:12 -0400
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


October 5, 2010
Visit the Forums
"Hot Topics" Library
Change/Update Subscription


LIVING WITH HIV/AIDS


 How Can I Raise My Levels of "Good Cholesterol"?
My "bad cholesterol" (low-density lipoprotein, or LDL) is low, but so is my "good cholesterol" (high-density lipoprotein, or HDL), and it's been that way for a while. What does HDL do, and what steps can I take to increase my HDL level?


 Why Does the AIDS Diagnosis Stick, Even When an HIVer's Condition Improves?
If a person's CD4 count bounces back up above 200, or they beat an opportunistic infection, they're still considered to have AIDS. Why is that? Why, when I haven't had an AIDS-related illness in 17 years and my CD4 count is 920, do I still have an AIDS diagnosis when I simply have HIV disease?


MIXED-STATUS COUPLES


 My Partner Loves Poppers: Are They Risky for Me?
I'm HIV positive, my partner is negative and we practice safe sex. My partner loves poppers and other inhalants. I don't care for them but when we get "rough and tumble" he pulls them out. I figure that whatever he's inhaling, so am I, so I'm wondering how safe inhalants are for HIV-positive folks. Do you have any information about this?


 Blow Job With Bleeding Gums During PEP: Should I Extend My Course?
I had a case of broken condom with my HIV-positive boyfriend. I immediately started on post-exposure prophylaxis (PEP) with Atripla (efavirenz/tenofovir/FTC), which is what my boyfriend takes. Ten days into PEP, he performed oral sex on me, and the next morning we discovered that his mouth was bleeding and that my penis had come in contact with his blood. Should I take PEP for 10 more days (38 total)?


Also Worth Noting: Visual AIDS

Image from the October 2010 Visual AIDS Web Gallery
"Untitled (Physician Desk Ref. #1)," 1993; Gin Louie

Visit the October 2010 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery, entitled "OSC: Obsessive Sex Collecting," is curated by Sarah Forbes.
BODY SHAPE CHANGES & HIV/AIDS


 Does Medicaid Cover Lipoatrophy Treatments As Well As Medicare?
If treatment for facial wasting is now supposed to be covered by Medicaid, why do all my doctors say they know nothing about it?


 What's the Next Step in Making Sure Medicare Makes Facial Fillers More Accessible?
I consulted with a trusted specialist who told me she doesn't know of any plastic surgeons or dermatologists in our state that even accept Medicare. Why don't doctors want to accept Medicare for facial fillers, and what would need to happen to make them more willing?


HIV TRANSMISSION & TESTING


 Now That My Partner and I Are Both HIV Positive, Do We Still Need to Use Condoms?
I was recently diagnosed with HIV, which I contracted through unprotected sex with my partner (I've known he was positive since before we were in a relationship). Now that we are both positive, is it still necessary to use condoms? I understand the potential risk of reinfection if I have unsafe sex with another positive person, but what if it's the person whose virus I was initially infected with?


 Is the Blood Donation Center Telling Me I'm HIV Positive?
I donated blood earlier this year. After some time I received a letter from the blood donation center telling me that I could no longer donate blood because I had a "reactive" result on my specimen. Does this mean I'm HIV positive? What should I do next?


HIV/AIDS TREATMENT


 What's Up With the Study of Cancer Drugs to Treat HIV?
I heard about a recent study using two cancer drugs to effectively force the HIV virus to mutate itself to death, or so the article I read said. Are there further studies in the works to see how this information could be used to treat or even cure HIV?


 Do HIV Meds Affect Digestion?
Does taking HIV meds have an effect on the way a person's body digests food?


 Are There Any Interactions Between Cocaine and HIV Meds?
I have a client who's taking Intelence (etravirine), Isentress (raltegravir), Norvir (ritonavir) and Prezista (darunavir) and also uses cocaine. Are there serious interactions between coke and these HIV meds? What other issues should I consider as a clinician?


More Questions About HIV/AIDS Treatment:


Connect With Others

Just Diagnosed and Feeling the Need to Share
(A recent post from the "I Just Tested Positive" board)

I am positive. It's a very terrible thing that I never ever imagined in my life. I don't know what I should do now. I do not believe much in the treatment in my country, but I know I have to do anything I can to make my life last the longest that it could. For anyone with a project in Viet Nam, or just some kind words to help me, please answer me! I need to see the light so I can have hope. -- PeacePhan

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!



OTHER HEALTH ISSUES & HIV/AIDS


 Never Finished My Course of Syphilis Treatment: Should I Be Worried Now?
I was infected with syphilis about a year ago. I had treatment at the time it was discovered, but I didn't go back for my second set of penicillin shots because my symptoms were gone. Earlier this year I found out I still have it. I've had another set of shots, but I now have a chancre of some sort on the tip of my penis. Should I be concerned?


 Alcoholic With Liver Problems: Should I Switch Meds to Reduce Liver Damage?
I'm HIV positive and I started meds with Truvada (tenofovir/FTC) and Viramune (nevirapine) in February. I'm also an alcoholic. I've tried everything to control my alcoholism, from detox to Alcoholics Anonymous, but nothing's worked; it seems I'm stuck with both HIV and alcoholism, for now at least. My last tests showed an undetectable viral load, but my CD4 count has dropped from 540 to 350 and my liver function tests were off the charts. Should I consider switching meds if my liver function continues to decline and my CD4 count doesn't improve? What else can I do?


UNDERSTANDING HIV/AIDS LABS


 Can You Explain PCR Testing?
I've seen many posts on these forums referring to PCR testing for HIV. What is the purpose of the PCR test? Is there ever a reason to take a PCR test beyond the six-month mark when an antibody test would be conclusive at that point?


STRANGE BUT TRUE


 Soap and Water Reduce HIV Risk! ... Right?
I had sex with the UPS man who delivers to my work. I was alone in the office one day and we ended up hooking up. It was sort of spur of the moment and we didn't have a condom so he washed his penis with soap and water first. He told me he washed off anything unsafe. Knowing that his penis had just been cleaned, how risky was this encounter?



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
The HealthCentral Network, Inc.
250 West 57th Street
New York, NY 10107





Activist Central

 Join a Facebook and Twitter Campaign to Fight NY Gov. Paterson's Rent Cap Veto!


 NIAID to Host Public Meeting on Future HIV/AIDS Research Networks


 Action Alert: Say NO to Abstinence-Only Sex Education


 President Obama: Address the ADAP Crisis!


 NMAC Asks for Your Help Ending S.B. 1070; Promoting Comprehensive Federal Immigration Reform


 Action Alert: Help Homeless AIDS Activist Get Into Housing Today


Monday, October 04, 2010

Report from the Aging and HIV Workshop- Frailty


Today was the start of the first international workshop on Aging and HIV in Baltimore.

The program was started by Dr L. Ferrucci who gave the first presentation on frailty. He works in geriatrics and presented general data from previous studies in the general aging HIV negative population. He presented compelling data that showed that people lose lean body mass (via a syndrome. called age related sarcopenia) and strength in people as they age, and those decreases are correlated to higher mortality. Also, inflammation markers like interleukin 6 increase with age, and levels of over 2.5 pg/ml in the blood have been linked to disability due to loss of muscle strength and mass. He also added that aging related inflammation can decrease brain volume and may be implicated in depression and other health issues.

Dr Joseph Margolick from the MACS Cohort presented previously published frailty data from this cohort that followed 4959 men who have sex with men since 1984 until 2006. Some of these men got infected with HIV and have been followed up before and after infection. A total of 1045 patients with HIV were followed. 75% of them had undetectable HIV viral load.

The frailty related phenotype (FRP) (i.e., the physical characteristics of frailty) was identified using 1 item selected from the questionnaires for each of the following 4 components: weight loss (answer yes to since your last visit, have you had unintentional weight loss of at least 10 pounds), exhaustion [answer yes to during the past 4 weeks, as a result of your physical health, have you had difficulty performing your work or other activities (for example, it took extra effort)?], slowness (answer yes, limited a lot to does your health now limit you in walking several blocks?), and low physical activity level (answer yes, limited a lot to does your health now limit you in vigorous activities, such as running, lifting heavy objects, participating in strenuous sports?). The assessment of weakness (ie, grip strength) was not incorporated into the MACS protocol until October 2005 and therefore could not be used in defining the FRP. A participant was considered as having the FRP at the visit if at least 3 of the 4 components were present. The FRP thus defined had a prevalence of 4.4% among MACS HIV-uninfected men aged 65 years and older, which was similar to the prevalence of frailty observed in the Cardiovascular Health Study for men of similar ages.

Frailty improved with the introduction of HAART. However, after adjusting for most important factors, frailty was still higher in HIV+ men compared to HIV- men. In fact, frailty of a 55 year old HIV+ man may be similar to that of a 65 year old HIV negative man.

Basal metabolic rate has also been found to be higher in HIV+ men compared to HIV- ones.

No therapeutic intervention data was presented to review the effect of exercise, testosterone replacement, and other factors on frailty in HIV+ men.

Sunday, October 03, 2010

Blogging from the HIV and Aging Wksp


I will start blogging tomorrow from this new workshop. I am glad we will be able to discuss the issues related to the seemingly accelerated aging that some long term survivors are experiencing. Tomorrow we will be listening to presenters speaking about frailty, immunology of aging, immunosenescense, neurocognitive changes, bone loss, vitamin D deficiency and drug interactions. Stay tuned! Nelson

Friday, October 01, 2010

HIV-resistant cells work in mice. Can they help humans?


latimes.com

HIV-resistant cells work in mice. Can they help humans?

California scientists, boosted by stem cell research funding enabled by Proposition 71, are aiming for clinical trials involving gene therapy through bone marrow transplants.

By Rachel Bernstein, Los Angeles Times
6:44 PM PDT, August 21, 2010




Clad in a yellow gown, blue foot covers, hair net, face mask and latex gloves, Paula Cannon pushed open the door to the animal room. "I hate this smell," she said, wrinkling her nose.

The stink came from scores of little white mice scurrying about in cages. Some of the cages were marked with red biohazard signs, indicating mice that had been injected with HIV.

Yet, in some of the animals — ones with a small genetic change — the virus never took hold.

Like mouse, like man? Maybe so.

In early 2007, a patient in Berlin needed a bone marrow transplant to treat his leukemia. He was also HIV positive, and his doctor had an idea: Why not use the marrow from one of the rare individuals who are naturally resistant to HIV and try to eradicate both diseases at once?

It worked. Sixty-one days after the patient's transplant, his virus levels were undetectable, and they've stayed that way.

Since news of the man's cure broke, HIV patients have been telephoning doctors to ask for bone marrow transplants. But it's not that simple. The treatment is too risky and impractical for widespread use.

"A bone marrow transplant — it's a horrible process you would not wish on your worst enemy unless they needed one to save their life," said Cannon, a biology professor at USC's Keck School of Medicine. There are grueling treatments to prepare a patient for transplant; the danger of rejecting the marrow; and the risk of graft-versus-host disease, wherein the marrow attacks the patient.

And that's assuming the patient can find a matching donor — a difficult proposition in itself — with the right HIV-resistant genetic constitution, which is present in only about 1% of the Caucasian population.

But there could be another way.

Instead of sifting through the sands for a rare donor and then subjecting a patient to the dangers of a bone marrow transplant, Cannon and her colleague Philip Gregory, chief scientific officer at the Richmond, Calif.-based biotech company Sangamo BioSciences, began to think: They could use gene therapy instead, to tweak a patient's own cells to resistance — and recovery.

The mouse "cure," they say, suggests they're on the right track.

Now, with $14.5 million from the California Institute for Regenerative Medicine, the San Francisco-based stem cell research-funding center created by 2004's Proposition 71, Cannon, Gregory and researchers at the City of Hope cancer center in Duarte are working toward bringing the technique to clinical trials within four years.

Cannon and other HIV researchers insist that, despite cancers and deaths associated with past gene therapy trials, it's the right way to target the disease. They cite recent successes, including treatments that cured children with the "bubble boy" syndrome and helped blind children regain their vision.

"I don't think anyone would want to do gene therapy if there were an alternative," said Caltech biologist David Baltimore, one of the many L.A.-based researchers pursuing gene therapy strategies to prevent or cure HIV. "I think it's absolutely necessary. Nothing else will work."

Since AIDS emerged in the early 1980s, development of anti-HIV medications has turned the disease from a virtual death sentence into a chronic, manageable condition.

But the clamor for a cure hasn't quieted.

Vaccine trials have failed; drug-resistant strains are on the rise; and the meds, which can have uncomfortable side effects such as fatigue, nausea and redistribution of body fat that creates a so-called buffalo hump, cost about $20,000 a year.

A bone marrow transplant is about five times as expensive, but it would have to be done only once.

The question was, could researchers create bone marrow stem cells that — just like the marrow the Berlin patient received — lack the crucial gene, CCR5, that normally lets HIV into the key immune cells it destroys?

In 2006, Gregory asked Cannon if she was interested in testing whether a tool his company developed, called a zinc finger nuclease, could do the trick.

Zinc finger nucleases are genetic scissors, cutting DNA at a specific site — say, in the middle of the CCR5 gene. When the cell glues the gene back together, it usually makes a mistake, resulting in a gene that no longer works.

"It just jumped out at me as, 'Oh my gosh, that's actually something that could work,' " Cannon said.

The team spent about a year optimizing the procedure for treating delicate stem cells with the CCR5 snippers.

They tested the method using so-called humanized mice — ones engineered to have a human immune system — because HIV doesn't infect normal mice. When stem cells were treated with the molecular scissors before being injected into mice, the resulting immune system lacked CCR5, exactly as the scientists had hoped.

These mice acted just like the Berlin patient — they fought off the virus.

Ready to make the leap from mouse to man, Gregory found a third leg for the team: researchers at City of Hope, who had extensive bone marrow transplant expertise.

"They brought Paula's data to us and we said, 'Wow, this looks fantastic,'" said Dr. John Zaia, City of Hope's deputy director for clinical research.

Researchers there are now working toward clinical trials, optimizing every element of the treatment for safety, effectiveness and reproducibility.

On a wiltingly hot afternoon in July, lab manager Lucy Brown maneuvered a computer mouse across three screens speckled with red, yellow and green dots.

The computer was hooked to a flow cytometer — a collection of black boxes, green wires and silver knobs that can detect subtle differences between cells and separate them at a rate of 50,000 per second. This is how the scientists will separate stem cells from patients' blood once trials are underway, to be sure that the genetic fix in the CCR5 gene was made, and kept.

Upstairs, machines with mazes of sterile tubes and pumps stood ready to prepare cells for CCR5-snipping. Here, the scientists will purify the bone marrow stem cells, increasing their numbers first to 5% of total cells, up from a measly 0.1% in the starting mixture, and then to 99%. At this point they can begin testing methods to clip the cells' DNA.

When all is perfected, the scientists will have a precise recipe for producing batches of engineered stem cells, including exactly how long the cells should be treated, how much of each chemical needs to be added, how pure the cells need to be, and thousands of other details.

"We are literally writing the book on how you do this," said David DiGiusto, director of City of Hope's bone marrow stem cell therapy research.

To receive FDA approval for clinical trials — a goal they hope to achieve in three to four years — the researchers must prove that they can safely and reliably prepare the cells. Once they get the green light, the first cases will probably be people like the Berlin patient who need bone marrow transplants to treat AIDS-related lymphoma.

They'll modify the patients' cells in the stringently sterile manufacturing lab that DiGiusto designed with details such as cove molding and seamless floors so there are no corners or cracks to collect dust. Anyone who enters must wear a full bunny suit, much like the one Cannon wears in her mouse room, to keep from contaminating the delicate cells.

Some have advertised the effort as a quest for the elusive "C" word, but Cannon doesn't quite see it that way.

"People say we're trying to cure HIV," she said. "I think of it more as, we're just trying to make the body live quite happily and healthily with a small amount of virus."


Wednesday, September 15, 2010

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


Sent via Blackberry


From: "News at The Body" <update@news.thebody.com>
Date: 15 Sep 2010 17:36:15 -0400
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


September 15, 2010
Visit the Forums
"Hot Topics" Library
Change/Update Subscription


LIVING WITH HIV/AIDS


 How Can I Make Up for a Stressful, Unhealthy Lifestyle?
I take Norvir (ritonavir), Reyataz (atazanavir) and Truvada (tenofovir/FTC), and I'll be honest: I don't eat very healthily and I smoke a pack of cigarettes a day. I'm also under a lot of stress, which my doctor says is responsible for my viral load fluctuating a lot (it's now about 1,200, and my CD4 count is 500). I'm looking for vitamins or something to help me maintain good health. Can you make any suggestions?


 Research for a Cure: What Can We Expect in the Next 5 to 10 Years?
It's so depressing that I'm HIV positive at the age of 26. I had a long life to look forward to, but it doesn't feel that way anymore. I started HIV meds right away and I'm doing OK, but is there anything to hope for as far as getting closer to a cure? What cure research is going on? What can we expect in the next 10 years besides newer meds?


BEYOND HIV/AIDS MEDICATIONS


 Why Haven't I Lost More Weight?
I exercise five days a week with a mixture of cardio and weights, but my weight seems to have stalled. It's been the same for the last few months, even though I can see that my shape has changed. I'm 5 feet 1 inch tall and about 168 pounds, with a medium frame. I don't look enormous and have good muscle mass. What can I do to give things a boost without living at the gym?


 Is Vitamin Supplementation Necessary for HIVers?
I'm finishing a research trial and am currently taking Truvada (tenofovir/FTC) and either TMC278 (rilpivirine) or Sustiva (efavirenz, Stocrin). I'd been taking Perfect Blend vitamins (four pills per day) for the last nine years, as well as creatinine supplements for the last year or so. My creatinine levels went up so my doctor had me stop taking all supplements. Now my viral load is undetectable and my CD4 count has been climbing -- it's now around 450. I still feel healthy even without taking supplements. I eat a balanced diet and exercise regularly, which I've been doing for the last 25 years. I'm now 48 and in good shape. Do I really need to start taking vitamins again? What are your thoughts on this?


Also Worth Noting: Visual AIDS

Image from the September 2010 Visual AIDS Web Gallery
"Heartbread," 1992; Bruce Cratsley

Visit the September 2010 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery, entitled "Sida," is curated by Rick Castro.
HIV/AIDS TREATMENT & SIDE EFFECTS


 Should I Switch Off Meds That Turn My Eyes and Skin Yellow?
I found out last year that I was HIV positive. Three months later I was put on Norvir (ritonavir), Reyataz (atazanavir) and Truvada (tenofovir/FTC). A couple weeks later my eyes and skin turned yellow. My doctor said it was a drug reaction and would clear up after a couple months. I've seen improvement over time, but my eyes are still yellow and it's not going away. I started drinking more water, but nothing is helping. Would it be safe for me to switch meds?


 Which Regimen Is Best for Taking Once at Bedtime?
I take Sustiva (efavirenz, Stocrin) and Truvada (tenofovir/FTC), but due to an anxiety disorder I'd like to change to a regimen I can take once at bedtime, with less chance of liver toxicity and cholesterol increase and not too many pills. What are the best options for me?


More Questions About HIV/AIDS Treatment & Side Effects:


OTHER HEALTH ISSUES & HIV/AIDS


 Will Erectile Dysfunction Drugs Interact With My HIV Meds?
What does an HIVer need to know when taking erectile dysfunction drugs with HIV meds -- especially protease inhibitors?


 Family Planning for Mixed-Status Couples: What Are the Options?
I am an HIV-positive man with an undetectable viral load and my fiancé is HIV negative. What are our options when it comes to conceiving a child? How high is the risk of her or the baby becoming HIV positive?


Connect With Others

Side Effects on Isentress: Does Anyone Have Experiences to Share?
(A recent post from the "Living With HIV" board)

I have been taking Isentress for about a month ... Abnormal dreams, insomnia and excessive fatigue have been side effects and seem to be ones for a lot of people. Does anyone have experience with this drug? Did the side effects get better? How long did that take (knowing that everyone's body is different)? ANY info will help ... I am very depressed about this. -- design36

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!



STRANGE BUT TRUE


 Should I Trust My Symptoms -- or My 16 HIV-Negative Test Results?
I had an occupational exposure to HIV in 1989. I have not had any other risk factor since then, and I've been tested 16 times in the past 21 years -- all negative. Now I'm having several early symptoms of AIDS. I am so terrified I can hardly function. Should I get another HIV test?



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
The HealthCentral Network, Inc.
250 West 57th Street
New York, NY 10107


Advertisement



Activist Central

 Action Alert: Say NO to Abstinence-Only Sex Education


 President Obama: Address the ADAP Crisis!


 NMAC Asks for Your Help Ending S.B. 1070; Promoting Comprehensive Federal Immigration Reform


 Action Alert: Help Homeless AIDS Activist Get Into Housing Today


Support PoWeR

Program For Wellness Restoration

Health News

Blog Archive

The Cure of HIV is Possible in Our Lifetime