Fw: Hot Topics at The Body’s “Ask the Experts” Forums

From: “News at The Body” <update@news.thebody.com>
Date: 22 Feb 2011 16:02:40 -0500
To: <powertx@aol.com>
ReplyTo: “News at The Body” <update@news.thebody.com>
Subject: Hot Topics at The Body’s “Ask the Experts” Forums

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February 22, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



LIVING WITH HIV/AIDS
 What’s Your Take on the HIV Gene Therapy Study Looking for an Effective Cure?
In light of the bone marrow transplant that effectively cured the “Berlin patient,” San Francisco researchers are recruiting HIV-positive volunteers for a study that uses a less invasive approach: gene therapy to modify patients’ immune systems. Have you heard of this study? What are your thoughts?

Benjamin Young, M.D., Ph.D., responds in the “Choosing Your Meds” forum

 What Do You Know About Zinc Supplements?
I read that taking zinc has been proven to make the common cold last for a shorter time. Have you heard about this? What else does zinc do? Is zinc good for the immune systems of HIV-positive people?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 Recently Diagnosed and Doing Fine: Has My Diagnosis Just Not “Sunk In” Yet?
I got diagnosed with HIV three weeks ago; my husband is HIV negative. My initial shock lasted about five to 10 minutes. We both took a week off from work and studies; now we’re back to our daily lives. I live in a country with very advanced medical care that’s all free. My husband is very supportive. We’ve been reading and talking a lot about HIV. Do you think I’m so optimistic because my diagnosis hasn’t really sunk in yet, and I might crumble later?

David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum
MIXED-STATUS COUPLES
 My Partner’s HIV Positive but I Keep Testing Negative: Can We Keep Having Unprotected Sex?
My partner tested HIV positive; I’ve had three different tests and they’ve all been negative. How is this possible? Can we continue to have sex without protection?

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

Also Worth Noting: Visual AIDS
Image from the February 2011 Visual AIDS Web Gallery
“Jesus Crowned … Black Madonna Glowing,” 1999; Gregg Cassin

Visit the February 2011 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month’s gallery, entitled "Why Religious Images Now?," is curated by José Vidal.

BODY SHAPE CHANGES & HIV/AIDS
 If Sculptra Stops Working, What Are Some Other Options?
Sculptra (poly-L-lactic acid, New-Fill) is a great product and it worked for me for years — but now it’s apparently stopped being effective for me. I’m afraid a very small percentage of people’s bodies may become immune to it. Can you suggest some other permanent facial-filler options?

Gerald Pierone, M.D., responds in the “Facial Wasting” forum
HIV/AIDS TREATMENT
 Low but Detectable Viral Load in First Trimester: When and With What Should I Start Treatment?
I’ve just completed my first trimester of pregnancy. My viral load was a little above 1,000 before my pregnancy, and my CD4 count was 820. Should I start treatment at this point? If so, which potential regimens do you suggest?

Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum

 Is It Safe to Reduce My Truvada Dosage?
I was diagnosed with HIV in August 2010 during acute infection and started taking Isentress (raltegravir) and Truvada (tenofovir/FTC) right away. My viral load at the time was 4.5 million copies; now it’s undetectable. My CD4 count went from 187 to a current 700. I don’t have any noticeable side effects yet, and my kidney function is good. However, I want to reduce my Truvada dosage to half a tablet daily or one full tablet every other day in order to minimize the risk of developing side effects in the long term. Does this make sense for me to do?

Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum

More Questions About HIV/AIDS Treatment:

OTHER HEALTH ISSUES & HIV/AIDS
 How Do I Figure Out Why I’m Tired All the Time?
I’m 47 years old, I got an AIDS diagnosis in 1999, had a stroke in 2001 and developed epilepsy. Now, despite testosterone shots and B12 complex supplements, I’m fatigued and exhausted all the time and I can’t work. I take antidepressants but they don’t make any difference. What should I do?

Robert J. Frascino, M.D., responds in the “Fatigue and Anemia” forum

 How Can I Relieve Yeast Infections Caused By My Antibiotics?
I’m a 43-year-old, uncircumcised man and I’ve been HIV positive since 1998. I’ve been in decent health, but every time my CD4 count goes down they put me on antibiotics for a few months and I end up with yeast infections. I know that the antibiotics are causing this condition but my doctor doesn’t agree. What can I do?

Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum

More Questions About Other Health Issues & HIV/AIDS:

UNDERSTANDING HIV/AIDS LABS
 Is There a Certain Amount of HIV That My Immune System Can Kill?
Can our immune systems handle or kill a certain amount of HIV? If so, how does that work?

Mark Holodniy, M.D., F.A.C.P., C.I.C., responds in the “Understanding Your Labs” forum
Connect With Others Newly Diagnosed and Looking For Some Support.
(A recent post from the "I Just Tested Positive" board)

I am a straight 42-year-old woman who was diagnosed with HIV on January 4, 2011. I suffered a terrible illness that started around the middle of September 2010. I was hospitalized for eight days and was sick for nearly two months. I had never been so sick in my life. I tested negative while I was in the hospital and thought I was OK. But I tested again when a man I had been with for six months told me a woman he had been with tested positive. That test came back positive. Gulp.

As of now, my CD4 count is 640, my viral load is 22,000 and my CD4 percentage is 35%. Not bad, I suppose, but I would still rather not have HIV. Last week, I joined a clinical trial at San Francisco General Hospital, the very same spot where so many people suffered from AIDS back in the ’80s. Pretty ironic for an HIV newbie. Can anyone relate or offer some advice? — toolatelola

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HIV TRANSMISSION
 Why Can’t Mosquitoes Transmit HIV?
The way I see it, mosquitoes have a syringe-like mouth to suck up human blood, and it’s hollow like a metal syringe. Judging by this similarity, why is HIV transmission not possible by mosquitoes the way it is by sharing syringes?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum
STRANGE BUT TRUE
 Will a Wash and Pee Keep Away HIV?
A married, topless woman I don’t know recently flagged me into her hotel room, and we quickly had unprotected sex before her husband could catch us. I’ve never made such a stupid move, and now I’m worried about HIV. Right after I ejaculated I immediately pulled out to check for any cuts or nicks, and ran into the bathroom to wash my penis. I also urinated with force. Did I minimize my chances of becoming HIV positive by washing and peeing right after sex?

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

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Activist Central
 House Votes to Defund Planned Parenthood: Sign a Letter to Congress to Save Critical Services!

 Urge Your Elected Officials to Defend the Affordable Care Act

Fw: News & Views: The Financial Impact of Aging With HIV; Why the Search for a Cure Is Heating Up; and More

From: “News at The Body” <update@news.thebody.com>
Date: 17 Feb 2011 12:40:13 -0500
To: <nelsonvergel@yahoo.com>
ReplyTo: “News at The Body” <update@news.thebody.com>
Subject: News & Views: The Financial Impact of Aging With HIV; Why the Search for a Cure Is Heating Up; and More

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February 17, 2011 Top Stories at TheBody.com News & Views Library Change/Update Subscription


ON THE PERSONAL SIDE Nelson Vergel Nelson Vergel: The Long-Term $urvivor Dilemma
“As we speak more [at conferences] about the science related to aging with HIV … the communal anxiety of surviving and aging with HIV is not addressed,” HIV activist and fitness guru Nelson Vergel warns. In the first entry of his new blog on TheBody.com, Nelson talks about an aspect of aging and HIV that’s often overlooked by researchers: the effect it has on our wallets and our emotional well-being.

Maria T. Mejia Maria T. Mejia: Here We Go Again — Lab Results and My Fears
“I know what I should do and how I should act, but I guess my personality or my fears get the best of me,” Maria T. Mejia writes. Every four to six months, she goes for another round of blood work and an update of her CD4 count, HIV viral load and other vital numbers. And each time, her anxiety goes through the roof: “As my partner, Lisa, and my Mom tell me, ‘Everything will be OK!’ But how do they really know?”

Sharon Sharon: Aging With HIV and Going Strong (Video)
When she was diagnosed in 1988, Sharon felt as if she was the only woman in the world with HIV. Now 57, she’s a long-term survivor who speaks passionately about aging with HIV and the “happy hour” culture among some older people. In this video interview from our friends at The Positive Project, Sharon talks about her diagnosis 19 years ago, her initial loneliness and despair, and the reasons why she’s so public about her status despite persistent stigma.
Join the Conversation Rhonda (From Oklahoma City, Okla.) on “Why I Want to Show My Face After 20 Years

“I am a 46-year-old heterosexual woman, and I am so tired of the stigma. I’m tired of trying to be ‘hush, hush’ about it. It does make me feel like a criminal, or dirty. … So many people have no idea how close they are to getting it. Like you said, all it takes is one time. I just also happen to be one of the honest ones that tell. How many are there out there that don’t even tell, and go ahead and sleep with someone. … I am no different from anyone else, it is just that one of the times I chose to have unprotected sex impacted my life forever.”

Read the rest of Rhonda’s comment and join the discussion on this article!

HIV NEWS & VIEWS Kenyon Farrow Obama’s Proposed Budget Calls for Increases to HIV/AIDS Programs; Republicans Call for Cuts
This week, the White House unveiled its budget plan for the rest of this year — and it held a press conference specifically to discuss how the budget will impact HIV prevention and care. “While we’ve heard in the press that the new budget includes cuts in most social spending domestically, there is actually increased funding in most HIV-related programs,” reports HIV/AIDS advocate Kenyon Farrow. The Republican budget proposal, however, tells a very different story.

Candace Y.A. Montague Some Question Focus of “AIDSWatch” as Activists Descend on Washington, D.C.
This week, HIV/AIDS advocates (and aspiring advocates) from across the U.S. have gathered in Washington, D.C., for AIDSWatch, a huge annual lobbying and activist-training event. But does the mission of AIDSWatch accurately reflect the needs of the HIV/AIDS community? Candace Y.A. Montague explores an apparent rift among HIV/AIDS activist groups.

More HIV News & Views Headlines:

Connect With Others Starting Meds Soon. Need Advice!
(A recent post from the "Living With HIV" board)

“To anyone who is interested, I have great news! My doc just got my genotyping and resistance tests back and it is very good! My virus is HIV-1, with no mutations! It has tested 100% susceptible to all drugs in all categories! I feel really encouraged by this! I meet with my doc on Wednesday to decide on my medication regimen. I feel strongly that I want to start on Atripla (efavirenz/tenofovir/FTC). I probably cannot get all three into one neat pill cost effectively over here, but can get all three drugs individually. My doc did a lot of reading and feels comfortable with this. Any ideas anyone has about this would be helpful.”

 — Pos_in_Thailand

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HIV TREATMENT & HEALTH ISSUES Dr. Bob Dr. Bob: The Search for the Cure Heats Up! Part Two: Why Now?
What’s behind the renewed urgency we’ve seen of late toward developing a cure for HIV? In part two of his three-part perspective on the search for a cure, Bob Frascino, M.D., points to seven key reasons why the hunt has been reinvigorated.

Paul Sax, M.D. Is the “Non-Suppressive HIV Drug” KP-1461 Worth Getting Excited About?
Researchers are constantly searching for new, innovative ways to fight HIV. One particularly intriguing candidate is KP-1461, which appears to work by trying to mutate HIV to death. Paul Sax, M.D., tells us a bit about this drug in development, and takes a moment to keep it real when it comes to getting overly excited about new HIV drug possibilities.

More Headlines on HIV Treatment and Health Issues:


HIV TRANSMISSION & EDUCATION Panelists The Rising HIV Rates Among Young Women and Girls of Color: What’s Going On? Part Two
Check out the conclusion of this critical look into HIV risk among young women in the U.S. A panel of prominent advocates explores the harsh social, cultural and economic realities that lead women and girls of color to put themselves in situations where they may be especially likely to get HIV — and what must happen to break this destructive cycle.

Rae Lewis-Thornton Rae Lewis-Thornton on Unsafe Sex: “I Just Don’t Get It”
Blogger Rae Lewis-Thornton is more than a little upset that, despite all we know about HIV and many other sexually transmitted diseases, so many people still have unprotected sex. “I’m not concerned with who you f***, that’s your business. I’m more concerned with how you f***. … There’s a lot of f***ing out there and … an equal amount of sexually transmitted diseases to match,” she writes. “So why, why, why would you put yourself at risk? I just don’t get it.”

Dee Borrego Helping People Understand the Needs of the Transgender HIV Community
For Dee Borrego, an HIV-positive transgender woman herself, witnessing the persecution her communities face has often led to frustration and heartbreak. But Dee still strongly believes that, “by being open and honest with those who have questions, we can educate and enlighten more people about what it means to be living with HIV and/or to be transgender nowadays.” In this op-ed, Dee lets off a little steam and talks about how the transgender community can help build bridges between “us” and “them.”

More HIV Transmission & Education Headlines:


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Activist Central
 Apply for the 2011 African-American HIV University Community Mobilization College

 Feb. 16: Is PrEP Prevention Justice? Join HIV PJA for Webinar on New Prevention Technology

 Register for AIDSWatch 2011 in Washington, D.C., February 16-18

HIV Gene Therapy Data Update

HIV Gene Therapy Data Update

HIV Gene Therapy Data Reported This Month

Sangamo Says Experimental Therapy Kept HIV Level Low
By Rob Waters – January 19, 2010 16:05 EST
Jan. 19 (Bloomberg) — Sangamo BioSciences Inc., a company developing gene-based therapies for AIDS and other conditions, said an experimental treatment kept down levels of HIV, the virus that causes AIDS, in the first patient tested in a study.
The patient interrupted his antiviral medications after infection-fighting cells that are targets of the virus were treated with the Sangamo product. His viral levels didn’t rise for six weeks, two weeks to four weeks later than typical patients who halt medication, Richmond, California-based Sangamo said today in a statement.
The therapy uses an engineered protein called a zinc finger nuclease to try and neutralize a receptor called CCR5 that HIV uses to enter and infect immune cells. This approach aims to replicate the immunity to HIV infection enjoyed by 1 percent to 2 percent of people whose own CCR5 genes are mutated.
The zinc finger technology “provides a totally new approach to HIV/AIDS with the aim of providing a reservoir of functional T-cells that are resistant to infection by HIV and available to fight opportunistic infections,” Dale Ando, Sangamo’s chief medical officer, said in the statement. “These data are an early indication that this may be possible.”


Sangamo’s Bet Against AIDS: Gene Therapy – “The bottom line: Sangamo BioSciences is testing a gene therapy for AIDS inspired by a cured patient. The first results come this month.”

Inspired by one man’s cure, the biotech tweaks patients’ genes

“preliminary data will be reported on Feb. 27 at a medical conference in Boston. Moussatos says that if the data are strong, Sangamo may attract partnerships with larger drugmakers that it will need to help finance larger trials.”
Video Interview with patient:
Feb 10, 2011, By Rob Waters
Timothy Brown may be the only person cured of AIDS. Brown, who lives in San Francisco, in 2007 received a stem-cell transplant in Berlin that transferred genetic material to him from one of the up to 2 percent of humans with a natural immunity to the disease. He has been off treatment since then, and no traces of the AIDS virus have been found in his body, says his hematologist, Gero Hütter, now with the German Red Cross in Mannheim. His case has encouraged tiny Sangamo BioSciences (SGMO) to develop a new form of gene therapy that could offer others the same result.
While there’s no guarantee Brown, 44, will remain virus-free, his case has spurred scientists to try to duplicate the result without a dangerous stem-cell transplant. Sangamo, a Richmond (Calif.) biotechnology company, will report data late this month on a gene therapy that’s likely to be less risky. If the results are a success, and the method is eventually approved, it may generate $750 million a year in U.S. sales, says Liana Moussatos, a biotech analyst at Wedbush Securities. “It’s high-risk, but definitely high-reward,” she says. “If this is a cure for HIV that prevents or reduces the lifelong need for drugs, that’s a huge accomplishment.”
Sangamo’s stock has more than doubled since July 6, when the company, with no products on the market, reported success of its gene therapy approach in mice in the journal Nature Biotechnology. One reason for the enthusiasm: The therapy, using a new technology that acts like biological scissors to cut into genes at precise points, may also treat other diseases, such as hemophilia, Parkinson’s, and neuropathy, the nerve damage caused by diabetes, says Sangamo Chief Executive Officer Edward Lanphier. An approved treatment for neuropathy alone, which has no cure, may generate $6 billion a year, Moussatos says.
Sangamo is conducting two studies of its HIV therapy in 21 people. Both are in the first stage of testing usually required to win U.S. regulatory approval. Its preliminary data will be reported on Feb. 27 at a medical conference in Boston. Moussatos says that if the data are strong, Sangamo may attract partnerships with larger drugmakers that it will need to help finance larger trials.
There are 1.1 million Americans living with the AIDS-causing HIV virus, and 34 million are infected worldwide, according to the U.S. Centers for Disease Control and Prevention. Antiviral drugs, led by Atripla and Truvada, made by Gilead Sciences (GILD) and Bristol-Myers Squibb’s (BMY) Reyataz, generated $15.1 billion in worldwide sales last year, according to industry researcher IMS Health.
AIDS first emerged in 1981 and, in the early years, killed most of those infected within a year of diagnosis. In 1996 doctors began combining three different families of drugs to overcome HIV’s ability to become resistant. That extended lives of patients in North America and Europe by at least 13 years on average, according to a 2008 study. Still, the drugs aren’t a cure, since the virus rebounds when their use stops. They are taken daily, often cause nausea, and can trigger kidney damage. They also need to be regularly adjusted as the virus mutates, gaining resistance in the body.
In the Sangamo process, doctors draw patients’ blood and remove infection-fighting white blood cells. They are then modified using naturally occurring proteins called zinc fingers that cut into patients’ DNA at selected points. Chopping the DNA in the middle of a gene called CCR5 eliminates a receptor that HIV uses to gain entry to cells. The modified cells are then returned to the patient through an infusion.
“This approach shows the most promise of any that I know of,” says Jay A. Levy, a researcher at the University of California in San Francisco who helped identify HIV as the source of AIDS in 1984. “It’s a terrific way of looking for a long-term functional cure for the virus.”
One person who hopes it will prove effective is Matt Sharp, 54, an AIDS educator who was diagnosed in 1988 and today takes a daily regimen of three antivirals. He learned about the Sangamo trial a year ago and enrolled. Since last summer, when Sharp received an infusion of his own gene-modified T-cells, blood cells that help the immune system fight infection, the number of those cells has doubled, he says. “I’m just hoping I could get an infusion once a year that would keep HIV under control and I won’t have to deal with the effects of taking medication.”
CCR5 isn’t a new target. The gene pathway was first noticed in the mid-1990s by scientists studying people immune to HIV infection. In these people, including the donor who contributed stem cells to Brown, the CCR5 gene is mutated and inactive, keeping the virus from gaining a foothold in the immune system. For most HIV patients, however, a stem-cell transplant is impractical and risky. It requires finding a donor with the CCR5 mutation and whose tissues and blood match the patient’s—and carries about a 30 percent risk of death, says Levy.
That’s too high a risk for most AIDS patients who have access to proven antiviral medicines. Brown, previously known in medical circles only as “the Berlin patient,” was willing to take the chance because he also had developed a potentially fatal case of leukemia—a blood cancer that can also be treated by stem-cell transplants. When chemotherapy stopped controlling his leukemia, Brown and his doctors decided to find a donor with genetic characteristics that would allow treatment of both conditions simultaneously. Brown underwent two stem-cell transplants. Afterward he developed neurological problems and other side effects and spent a year in the hospital, at some points near death. He eventually recovered and was released in early 2009.
“If I hadn’t survived, I kind of doubt that the work towards a cure would have gone this far,” Brown says. Now he hopes scientists will be able to develop new therapies based on his treatment “so people can be cured of HIV without having to go through what I went through.”
——————————

Zinc Fingers Disrupts CCR5/HIV Entry; Sangamo and the University 

Dec 28, 2009  Sangamo BioSciences, Inc. (Nasdaq: SGMO) announced today that its collaborators at the University of Pennsylvania have opened a Phase 1 www.natap.org/2009/newsUpdates/122909_01.htm

Sangamo BioSciences Initiates Phase 1 Trial of CCR5-ZFP 

Feb 3, 2009  Sangamo BioSciences, Inc. (Nasdaq: SGMO) announced today that its collaborators at the University of Pennsylvania have opened a Phase 1 www.natap.org/2009/HIV/020409_01.htm

New Gene Therapy Zinc Fingers Research Published: ‘doctors may someday control HIV virus using stem cells without using anti-retroviral drugs’ ……’Human hematopoietic stem/progenitor cells modified by zinc-finger nucleases targeted to CCR5 control HIV-1 in vivo’ in Nature Biotevhnology July 2 2010……

New Gene Therapy Zinc Fingers Research Published: ‘doctors may 

Jul 2, 2010  Human hematopoietic stem/progenitor cells modified by zinc-finger nucleases targeted to CCR5 control HIV-1 in vivo 
www.natap.org/2010/HIV/070610_01.htm

Can HIV be cured with stem cell therapy? commentary

by SG Deeks – 2010 –Can HIV be cured with stem cell therapy? commentary. Steven G Deeks and Joseph M McCune. Nature Biotechnology July 2010 full text of study in mice:www.natap.org/2010/HIV/081010_01.htm
—————————-
Sangamo BioSciences Initiates Phase 1 Trial of CCR5-ZFP Therapeutic to Treat HIV/AIDS
RICHMOND, Calif., Feb 03, 2009 — Therapeutic Approach Provides HIV-Resistant Immune Cells
Sangamo BioSciences, Inc. (Nasdaq: SGMO) announced today that its collaborators at the University of Pennsylvania have opened a Phase 1 clinical trial to evaluate SB-728-T for the treatment of HIV/AIDS.
Based on Sangamo’s zinc finger DNA-binding protein nuclease (ZFN) technology, SB-728-T has been shown in an animal model of HIV infection to lead to an increase in CD4+ T-cell counts, a reduction in viral load and expansion of CCR5-modified T-cells, suggesting resistance to HIV.
“This is the first time that we have had the ability to make a patient’s T-cells permanently resistant to infection by CCR5-specific strains of HIV and we are very excited to begin a clinical trial of this novel ZFN-based therapy,” said Carl June, M.D., Director of Translational Research at the Abramson Family Cancer Research Institute at the University of Pennsylvania School of Medicine. “The ability to protect immune cells from infection with HIV and the expansion of CCR5-modified T-cells has the potential to provide long-term control of both the virus itself and eventually the opportunistic infections characteristic of AIDS.”
CCR5 is a co-receptor that enables HIV to enter and infect cells of the immune system. About ten years ago, it was observed that individuals carrying a natural mutation of their CCR5 gene, CCR5-delta32, were highly resistant to infection by HIV. These individuals, lacking a functional CCR5 (approximately 1-2% of the general population), are immunologically “normal”. A variety of small molecule and antibody antagonists of CCR5 binding have been tested and developed as potential therapeutic agents for the treatment of HIV infection. In addition, there is a recent report of a patient who had both HIV infection and leukemia and received a bone marrow transplant from a donor carrying the CCR5 mutation. After the successful bone marrow transplant, HIV treatment was discontinued and the virus could not be found in the circulating blood several months after the procedure. Sangamo’s ZFNs are designed to modify the DNA sequence encoding CCR5. This modification can occur directly in T-cells with only a brief exposure to the ZFNs. Once the modification is made to the T-cell’s CCR5 gene it is permanently disrupted.
“Our ZFN approach is very well-validated by naturally occurring mutations in man and the recent bone marrow transplant report,” commented Dale Ando, M.D., Sangamo’s vice president of therapeutic development and chief medical officer. “However, allogeneic bone marrow transplantation (bone marrow taken from a different person) is not widely applicable as a therapeutic approach for HIV as it is a risky procedure requiring irradiation and ablation of the immune system and matched donors who also carry the CCR5-delta32 mutation are likely to be rare. Small molecule or antibody antagonists require the constant presence of a high concentration of drug in order to block therapeutically relevant numbers of the CCR5 protein.
In contrast, we believe that our ZFN technology provides an approach that circumvents the dosing and potential toxicity issues of a systemic therapy and provides a simpler approach than a transplant. We specifically modify the patient’s own CD4+ T-cells, the principal target of HIV infection, with a one-time exposure of the cells to CCR5-specific ZFNs. This generates a population of T-cells that lack the CCR5 receptor, are resistant to HIV and can be infused back into the patient to provide a reservoir of HIV-resistant functional immune cells and, more importantly, may expand and provide an HIV immune response.”
“Our ZFP technology functions at the DNA level and, as this application demonstrates, enables us to address highly validated therapeutic targets that have proven difficult to drug at the protein and RNA levels,” commented Edward Lanphier, Sangamo’s president and CEO. “ZFPs can be engineered to regulate or modify any gene, in any cell type, which provides numerous opportunities for its therapeutic applications. This trial is another important step in establishing our ZFP technology as a major new therapeutic product development platform.”
About the SB-728-T Clinical Trial
The study is an open-label Phase 1 clinical trial of the safety and tolerability of a single infusion of autologous (a patient’s own) CD4+ T cells genetically modified at the CCR5 gene by CCR5-specific ZFNs (SB-728-T). A total of twelve subjects with HIV will be enrolled in this trial in two treatment cohorts. The first cohort to be treated comprises six subjects who have failed two or more HAART (Highly Active Antiretroviral Therapy) regimen. The first three subjects in this cohort will be treated sequentially and monitored for the first 21-days post treatment before an additional subject is treated. After this period of evaluation and monitoring has passed successfully, the next three subjects will be treated. The second cohort comprises six subjects who are responsive to their current therapy regimen who will be treated with CCR5-modified T-cells and undergo a structured therapy interruption (STI) or therapy “break”. The primary objective of the study is to evaluate the safety and tolerability of SB-728-T. In addition to safety monitoring, data will be collected on the expansion and persistence of ZFN-modified cells, CD4+ cell counts and viral load. Individuals interested in participating in this trial should visit http://www.clinicaltrials.gov/ or contact Larisa Zifchak, R.N. at 215-349-8091 (larisa.zifchak@uphs.upenn.edu), Joe Quinn at 215-349-8091 (joseph.quinn@uphs.upenn.edu) or Pablo Tebas, M.D. at 215-349-8091.
Preclinical Data
Preclinical data on SB-728-T were published in the journal Nature Biotechnology (Perez E. E. et al., Nat Biotechnol. 2008 Jul; 26(7):808-16.) and presented at the joint meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and the Infectious Diseases Society of America (IDSA) in Washington, DC in October 2008. The results demonstrate that a one-time exposure to CCR5-specific ZFNs resulted in the generation of an HIV-resistant population of human primary T-cells by the permanent genetic modification of the CCR5 gene. These ZFN-modified CD4 T-cells expanded stably in HIV-infected cultures for several weeks and appeared to behave identically to untreated T-cells except that they were resistant to infection by HIV. ZFN treated primary CD4 T-cells and transformed CD4 cell lines resisted infection with R5-tropic HIV (virus that uses the CCR5 co-receptor to enter cells), resulting in enrichment of ZFN-generated CCR5-disrupted cells in the population upon long-term exposure to virus (>50 days). Importantly, in the presence of HIV, ZFN-modified CD4 T-cells also preferentially expanded in a mouse model. The modified cells were infused into mice that lack a normal immune system and thus do not reject human cells. After 33 days, the mice were sacrificed and analyzed for the presence of ZFN-modified cells. Researchers determined that ZFN-modified cells engrafted normally in the mouse and that the proportion of modified cells present at the end of the experiment was greater than two to three fold higher in mice in the presence of HIV infection (p=0.008). In additional experiments it was determined that 50 days after infection, mice given the ZFN-modified cells had increased numbers of CD4 cells and a statistically significant reduction in viral load in their peripheral blood (P<0.001) compared to mice given control cells. These data suggest that, in the presence of HIV, the ZFN-modified cells have a selective advantage allowing them to evade infection and destruction leaving them able fight opportunistic infections and HIV itself.
About HIV/AIDS and CCR5
HIV stands for Human Immunodeficiency Virus. HIV infection kills or impairs cells of the immune system progressively destroying the body’s ability to fight infections and certain cancers resulting in AIDS (Acquired Immune Deficiency Syndrome). Individuals diagnosed with AIDS are susceptible to life-threatening diseases called opportunistic infections, which are caused by microbes that usually do not cause illness in healthy individuals. According to UNAIDS/WHO, over 2.7 million people were infected with HIV in 2007. There are now over 33 million people living with HIV and AIDS worldwide.
CCR5 is the chemokine receptor that HIV uses as a co-receptor to gain entry into immune cells. CCR5 is perhaps the most important of the known co-receptors for HIV, since the most commonly transmitted strains of HIV are strains that bind to CCR5 — so-called “R5” strains. A small fraction of the population carries a mutation in their CCR5 gene, called the delta32 mutation. This mutated version of the gene produces malformed CCR5 proteins, which cannot be used by HIV as a co-receptor. Individuals that have two copies of this mutant form of CCR5 (delta32) are resistant to infection by R5 HIV strains.
Dr. June is not affiliated with Sangamo BioSciences in any capacity beyond his role as a clinical collaborator on this project. 

Fw: Hot Topics at The Body’s “Ask the Experts” Forums

From: “News at The Body” <update@news.thebody.com>
Date: 09 Feb 2011 16:28:24 -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 9, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



LIVING WITH HIV/AIDS
 How Long Are HIVers Expected to Live Nowadays?
I’ve been HIV positive for 25 years. My CD4 count is around 500 and my viral load is undetectable. What’s my life expectancy? What would it be if I were a 20-year-old just starting HIV treatment today?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 How Can I Get More Energy?
I try to work out but I have no energy. Before I was diagnosed with HIV, I was exercising four days a week. I’m now down to three days a month. I’m on testosterone replacement therapy but it doesn’t help. How can I build up my energy — or find out why I have none so I can do something about it?

Nelson Vergel responds in the “Nutrition and Exercise” forum

More Questions About Living With HIV/AIDS:

MIXED-STATUS COUPLES
 Is Starting HIV Meds a Good Way to Keep My Partner HIV Negative?
I’m HIV positive and I’ve never taken HIV meds before. My CD4 count is 526 and my viral load is 317. My partner is HIV negative and we’d like to keep it that way, so we practice safer sex every time. We recently had a condom break and my partner took post-exposure prophylaxis (PEP). In case this happens again, I’m contemplating starting treatment to reduce my partner’s chances of becoming HIV positive. Do you think this is a good idea?

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

 If I Receive a Live Vaccination, Am I Putting My HIV-Positive Partner at Risk?
I’m the HIV-negative partner in a mixed-status relationship. There’s plenty of information on which vaccinations are recommended for people living with HIV, but can a negative partner’s immunizations put the positive partner at any risk? Should negative partners also avoid receiving “live virus” vaccinations?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum
welcome to our new "workplace and insurance issues" expert
Michael J. Van EssenThere’s another new expert on the block! Michael J. Van Essen has worked in benefits advocacy and outreach at several HIV/AIDS service organizations, and is equipped to answer questions on topics like health insurance, disability benefits, returning to work and much more. Mr. Van Essen joins longtime expert Lynn Franzoi in the “Workplace and Insurance Issues” forum. Learn more about Mr. Van Essen, and ask him a question in the forum!

BODY SHAPE CHANGES & HIV/AIDS
 Are Any Of My Meds Contributing To My Lipoatrophy?
I’ve been HIV positive for 24 years and on many different meds. My CD4 count is over 900 and my viral load is undetectable. I currently take Epzicom (abacavir/3TC, Kivexa), Lexiva (fosamprenavir, Telzir), Norvir (ritonavir) and Viread (tenofovir). I don’t want to be on any meds that could cause further facial wasting. Are any of these meds known to contribute to lipoatrophy? Which types of meds should be avoided, if possible?

Gerald Pierone, M.D., responds in the “Facial Wasting” forum

 What’s Going On With the Newly Approved Belly Fat Drug Egrifta?
I get my HIV meds through ADAP (AIDS Drug Assistance Program). My lipodystrophy belly is pretty big and I need to do something about it. What options are currently available to pay for Egrifta (tesamorelin)?

Nelson Vergel responds in the “Nutrition and Exercise” forum
HIV/AIDS TREATMENT & SIDE EFFECTS
 If You Were Diagnosed Today, Would You Start Treatment Right Away?
I became HIV positive last January and was very sick for a month. My CD4 count is now 590 and starting treatment no longer seems urgent, but I want to make sure the virus stays in check. Is there a downside to starting treatment now? What are the recommended regimens to start with, and what can I expect from each? With all the knowledge you have now, if you were diagnosed today, would you wait to start treatment?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 What Can Be Done About Bone Problems?
My husband is 35 years old and was diagnosed HIV positive in 2006. He’s been taking Viraday (efavirenz/tenofovir/FTC, the generic form of Atripla available in some countries outside the U.S.) regularly for three years. His numbers are good and he maintains an active, healthy lifestyle. However, he has regular bone-related problems in his wrists, elbows and ankles. Is this a side effect of Viraday? What can he do to reduce pain and build bone density?

Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum

 Do the Enzymes HIV Meds “Inhibit” Ever Do Anything Good?
I take a nucleoside reverse transcriptase inhibitor and an integrase inhibitor. Do these two enzymes have any positive effects for the body? Does inhibiting them cause any problems that we know of?

Mark Holodniy, M.D., F.A.C.P., C.I.C., responds in the “Understanding Your Labs” forum

More Questions About HIV/AIDS Treatment & Side Effects:

OTHER HEALTH ISSUES & HIV/AIDS
 Which Form of Niacin Works Best at Increasing Good Cholesterol?
I know that niacin supplements are known to increase levels of HDL (high-density lipoprotein, or “good cholesterol”). Since over-the-counter niacin can cause a “flushing” sensation on a person’s skin, which I can’t stand, I’ve been taking “no-flush” niacin (inositol hexanicotinate) for many years. It’s worked well generally, except when a brief switch to Lexiva (fosamprenavir, Telzir) caused my triglyceride levels to skyrocket. What do you know about the different kinds of niacin? Does the no-flush niacin work as well as regular “live” niacin at raising levels of HDL?

Nelson Vergel responds in the “Nutrition and Exercise” forum

 Why Do I Smell Something Foul All the Time?
For some reason, I smell a foul smell on me most of the time. I take my HIV meds and my doctor says I’m doing fine, but I feel like my body is rotting away. I was diagnosed with cryptococcal meningitis in 2005 — could that have something to do with this unusual condition?

David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum

More Questions About HIV/AIDS Treatment & Side Effects:

Connect With Others I Haven’t Dated Anyone in Years: How Can I Learn to Trust Again?
(A recent post from the "Gay Men" board)

I’m 38 and I was diagnosed almost seven years ago. … Dating has been very hard for me. I live in a rural part of the U.S. Shortly after I found out I was positive, I had two very horrible experiences of people telling a lot of people about my status, people who had no business knowing. It freaked me out enough that my answer was to just stop dating. It’s been six years and I’m not willing to just not date for the rest of my life. … I’m slowly putting myself back out there but I never know when the right time to reveal my status is and then I have flashbacks to the horrible incidents I had, get scared and shut down.

Has anyone else ever gone through this? Thanks in advance for any thoughts, ideas, etc. — alittlelost

Click here to join this discussion, or to start your own!

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UNDERSTANDING HIV/AIDS LABS
 My CD4 Count Is Slow to Increase: Does This Mean My Meds Don’t Work?
I started taking Atripla (efavirenz/tenofovir/FTC) three years ago. Although my viral load is now undetectable, my CD4 count is only 400 and it’s only ever gone as high as 500. Are my HIV meds not working? Should I start thinking about changing meds?

Joseph P. McGowan, M.D., F.A.C.P., responds in the “Choosing Your Meds” forum
HIV TRANSMISSION
 Seconds of Unprotected Sex With a Positive Partner: Should I Take PEP?
I had insertive anal sex with a person who later informed me he was HIV positive with an undetectable viral load. Before I penetrated him, I introduced my penis head to his anus for about 10 seconds at most. Right after, I put on a condom and started penetration. I noticed he started to bleed and I stopped. The condom was intact and I didn’t have any blood on my penis. It hasn’t been 72 hours yet; should I start PEP (post-exposure prophylaxis)?

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum
STRANGE BUT TRUE
 There’s No Sex in the Champagne Room … But Is There HIV Risk?
Recently I met a girl in the Champagne Room at a strip club. I fondled her boobs and eventually inserted my penis between them. There was no visible blood, cuts or breast milk on or between her boobs, but I did notice small red pimples. Can you assess the risk of HIV transmission in this case? I’m very worried!

Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

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Activist Central
 Feb. 16: Is PrEP Prevention Justice? Join HIV PJA for Webinar on New Prevention Technology

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Fw: 2011 Emergency ADAP Summit Attendees Send Letter to President Obama: Fix ADAP Crisis Now

From: Brandon Macsata <info@adapadvocacyassociation.org>
Date: Fri, 4 Feb 2011 06:52:56 -0800 (PST)
To: Nelson Vergel<powertx@aol.com>
ReplyTo: info@adapadvocacyassociation.org
Subject: 2011 Emergency ADAP Summit Attendees Send Letter to President Obama: Fix ADAP Crisis Now

ADAP Advocacy Association ADAP Advocacy Association
P.O. Box 15275
Washington, DC 20003
Email:info@adapadvocacyassociation.org
Web:http://www.adapadvocacyassociation.org


2011 Emergency ADAP Summit Attendees Send Letter to President Obama Seeking Fix to Ongoing ADAP Crisis; Uncertainty Fuels Growing Frustration among HIV/AIDS Activists

Summit Deemed Success by Attendees

WASHINGTON, D.C. (February 4, 2011) – The ADAP Advocacy Association, also known as aaa+, today sent a letter to President Barack Obama and his Office of National AIDS Policy director, Jeff Crowley, seeking an immediate fix to the ongoing crisis facing the cash-strapped AIDS Drug Assistance Programs (ADAPs). The letter, which was drafted and circulated for signatures during the 2011 Emergency ADAP Summit in Fort Lauderdale, Florida last weekend, demonstrates that ADAP stakeholders nationwide remain optimistic that their advocacy efforts will not be in vein.

“After an extremely successful summit – in which we proved our community can disagree, but still unite behind a common purpose – activists from across the nation re-committed themselves to fighting for the 5,779 people living with HIV/AIDS on ADAP waiting lists,” said Brandon M. Macsata, CEO of the ADAP Advocacy Association. “We’ve heard the rhetoric, now we want results. The President still enjoys widespread support in the HIV/AIDS community, and we’re hopeful that something is done before the ADAP waiting lists top six thousand Americans living with HIV/AIDS.”

Just prior to the summit convening, ADAP waiting lists ballooned to 5,779 in ten states – including Arkansas with 23 individuals, Florida with 3,008 individuals, Georgia with 879 individuals, Louisiana with 621 individuals, Montana with 19 individuals, North Carolina with 106 individuals, Ohio with 368 individuals, South Carolina with 359 individuals, Virginia with 395 individuals and Wyoming with 1 individual.

The ever-escalating ADAP waiting lists prompted summit attendees to send the letter to President Obama. The letter, which was signed by 57 people living with, and affected by HIV/AIDS, is provided below in its entirety:

[Begin Letter]

January 30, 2011

To: President Barack Obama
The White House
Washington, D.C. 20502

Mr. Jeffrey Crowley, Director
Office of National AIDS Policy
The White House
Washington, D.C. 20502
(202)456-4533
AIDSpolicy@who.eop.gov

Dear President Obama and Mr. Crowley;

We the undersigned have been together all this weekend, January 29-30, in response to the AIDS Drug Assistance Program (ADAP) emergency in Florida, and the ADAP crisis nationwide.

As we write, there is still uncertainty about whether 10,000 Floridians with HIV and AIDS whose lifeline is ADAP, will shortly be cut off from their medication.

What is certain is that unless an agreement can be reached for a proposed once-only rescue by the pharmaceutical industry, Florida’s ADAP funding will run out in less than two weeks, i.e. by February 10th. And even if there is temporary resolution, without adequate new funding there will be recurring shortfalls.

What is also certain is that;

  • As of last Friday, in ten states nationwide, 5,779 qualified HIV/AIDS patients in need are on waiting lists for access to ADAP medications.


  • Nineteen states and territories have severely tightened enrollment criteria and reduced drug formularies.


  • Between 2009 and 2010, monthly users of ADAPs rose an unprecedented 80%, and continue to rise due in large measure to the “perfect storm” of the downward spiraling economy with loss of jobs and health insurance, plus rising drug prices.


  • State budget deficits preclude addressing the accelerating need, while the federal Ryan White ADAP contribution has shrunk from approximately 70 percent to 50 percent of the overall national ADAP budget in recent years.


  • Research has shown that earlier treatment prolongs life, preserves productive individual health, and protects public health through lower viral counts and reduced disease transmission.


  • Pharmaceutical industry price accommodations and a $25 million HHS ADAP supplement in 2010, though deeply appreciated, as well as failed House and Senate legislative efforts, have left a current and ever-increasing shortfall of close to $100 million.


  • The President’s National HIV/AIDS Strategy, published July 13, 2010, calls for;

    1) reducing the number of people who become infected with HIV;
    2) increasing access to care and optimizing health outcomes for people living with HIV; and
    3) reducing HIV-related health disparities.

    None of these overarching goals can be approached while failure looms over the national Ryan White ADAP Program, especially between now and 2014 when Health Care Reform is more fully implemented.

    It is no exaggeration to say that Persons Living With, and Affected By HIV and AIDS are fearful and desperate in the face of government gridlock that has thwarted every constructive solution to the ADAP crisis.

    We implore you to take the lead and not to rest, until there is secure and sufficient funding – immediate and ongoing – to avert a Florida ADAP meltdown and national ADAP insolvency, to achieve the goals of the National AIDS Strategy, and most importantly, to prevent needless suffering and death of Persons Living With HIV and AIDS in the United States.

    Sincerely,

    [End Letter]

    The two-day summit focused on the continuing crisis facing the cash-strapped AIDS Drug Assistance Programs, filled with important updates, lively discussions and timely grassroots advocacy trainings.

    To learn more about the ADAP waiting lists or the ADAP Advocacy Association, please contact Brandon M. Macsata by phone at (305) 519-4256 or email at info@adapadvocacyassociation.org.


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    Hitting the gym with fitness stud Nelson Vergel

    From: Mark S. King <mark@marksking.com>

    Sent: Thu, Feb 3, 2011 4:31 am
    Subject: Hitting the gym with  fitness stud Nelson Vergel

    HIV advocate and fitness expert Nelson Vergel agrees to help me with a
    monumental task: losing weight.  In the second part of a three-part video
    series, we hit the gym for lessons on aerobic and weight training.
    
    If you had once told me that poz guys would be watching their waistlines and
    their bone density, I would have advised you to change your meds.
    
    Hitting the Gym with HIV Fitness Expert Nelson Vergel
    http://marksking.com/my-fabulous-disease/hitting-the-gym-with-hiv-fitness-expert-nelson-vergel/
    
    LOOK WHAT'S COMING UP:  a return tour of a gay sex club with a "poz night" and
    a discussion of serosorting; and a great prevention video made by one man that
    puts big budget campaigns to shame.
    
    My posts may always be shared with proper mention/link to My Fabulous Disease.
    
    You're on the "My Fabulous Disease" e-mail list.  To opt out, simply visit the
    site and unsubscribe. 
    
    Please be well,
    
    Mark S. King
    mark@marksking.com
    www.MyFabulousDisease.com

    Interview with author Nelson Vergel about his new book

    Full Nelson

    [ 0 ]February 1, 2011 | Steven Foster
    NelsonVergel slider Full Nelson featured

    Back by popular demand: author Nelson Vergel wrote Testosterone: A Man’s Guide in part to respond to men’s queries about their diminishing sex drives.
    Speaker, survivor, and author Nelson Vergel gives OutSmart the no-longer-skinny on ‘Testosterone: A Man’s Guide,’ his first book in over a decade
    by Steven Foster
    Steven Foster: It’s been 11 years since your first book Built to Survive hit the shelves and became an almost de facto manual for living with HIV. Why this book for your follow-up?Nelson Vergel: After my first book, I began to get a lot of e-mails from men—healthy men, not just men with HIV—who wanted to know if they needed to have HIV to get some help with hormone therapy. And that really struck me that we needed to begin providing this information.
    The book is incredibly comprehensive.
    It is time to package all of this information. But the information in here is practical—it’s not a textbook. This book basically has all the facts on how to manage side effects and maximize benefits, choose the right options, know if testosterone is for you. Not everyone should be using testosterone.

    What made these men write?
    The first thing people notice is not being very interested in sex. But it goes beyond that. You’re not connecting, you’re kind of lackadaisical about life. You’re not really depressed, but you’re in a funk. You don’t go out like you used to, you don’t enjoy hobbies like you used to. There’s no zest for life. The mood, the connection, the way you relate to others, the way you deal with stress.

    But doesn’t a loss of sexual drive occur naturally with age?
    As we age, testosterone goes down. Illnesses make testosterone go down. Sometimes there’s not a real reason why. I’m not saying that low testosterone is the only reason people have those symptoms. We all go through ups and downs. But if it’s a trend downward and you’re not that  old, then it’s a good thing to go to your doctor and have your testosterone checked.

    It seems like there’s such a stigma about that—men and low testosterone.
    The first step is to recognize you have a problem, and that’s very difficult for men. To admit they’re not at their best, that sexually they’re not interested in performing? Those subjects are moot to most men.

    Do most doctors just say, “Oh, here’s some Viagra”?
    Yes, a lot of doctors do that. Viagra is so easily prescribed. And people can find it online from other countries without a prescription. But it’s not the solution to the problem—it’s just a Band-Aid, using Viagra. And studies have shown that people with low testosterone respond very well to Viagra. But it doesn’t work as well or as long. And your drive and your hunger for sex is not enhanced by Viagra. With Viagra you need stimulation. You actually have to be driven to have the sex. Testosterone lights that fire. Viagra might just provide oxygen to that fire.

    What has testosterone replacement therapy [TRT] done for you?
    Saved my life. I’ve been HIV-positive for 27 years. In 1993 I was losing a lot of weight through the wasting syndrome before the protease inhibitors arrived. I was in Los Angeles and guys were using testosterone underground and they looked great. They had HIV like me, but they looked great. But I was all, I’m not gonna get on that, it’s gonna kill my liver and my immune system.

    TRT had bad press?It still does. But I’d lost 30 pounds already and I needed to do something because back then we didn’t have any meds. If I hadn’t gone to testosterone I would not have survived to ’96 or ’97 when the protease inhibitors came in and saved some of us. But a lot of my friends didn’t make it.

    What about the current view?
    Testosterone is not the answer to everything. It can create problems if you don’t know what you’re doing. But it’s like anything in life. If you’re taking a medication, you need to know what you’re doing. I’m very confident that anyone who has any questions about testosterone can find the answers in this book.

    Fw: Hot Topics at The Body’s “Ask the Experts” Forums

    From: “News at The Body” <update@news.thebody.com>
    Date: 01 Feb 2011 18:16:13 -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 1, 2011 Visit the Forums “Hot Topics” Library Change/Update Subscription



    LIVING WITH HIV/AIDS
     Loss of Libido After Diagnosis: Is This the End of My Sex Life?
    I haven’t had sex in the three years since my HIV diagnosis. At 44, my testosterone levels are actually higher than normal and aside from HIV, I’m in very good physical health. The first year or two I figured that, after some time had passed and the initial shock of my diagnosis had worn off, sex would once again be part of my life. That time has come and gone and I still have no desire to be sexual with another man. Is there anything I can do to jump-start my sexual desire?

    David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum

     How Do I Deal With Having HIV?
    I cannot deal with the mental anguish of having HIV. I keep waiting to develop drug resistance or something else bad to happen. I just want it to be over and I’m considering just not bothering anymore. I’m seeing a counselor and was put on Wellbutrin (bupropion), but I still can’t cope. What can I do? How long have others you’ve known been able to deal with this?

    David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum
    NUTRITION, EXERCISE & HIV/AIDS
     Any Tips for Eating Well and Losing Fat?
    I’m doing well on Atripla (efavirenz/tenofovir/FTC). My viral load is undetectable and my CD4 count is around 400. But I’ve gained more than 40 pounds and I need to lose some weight. Also, my bowel movements are all loose, and most have an oily film floating on top of the water. What could be causing this? Do you have any everyday fat-loss and nutrition tips for me?

    Nelson Vergel responds in the “Nutrition and Exercise” forum

     Can an HIVer Still Train to Run a Marathon?
    I’ve been HIV positive for five months. I now take medication and I feel good. Would it be possible for me to start a training program to run a marathon?

    Nelson Vergel responds in the “Nutrition and Exercise” forum
    MIXED-STATUS COUPLES
     Is Natural Conception Really Possible For Mixed-Status Couples?
    I asked my doctor what other options are available for mixed-status couples wanting to have a child, aside from IVF (in-vitro fertilization) and sperm washing. He said that as long as the HIV-positive partner’s viral load remains undetectable, it is indeed possible to conceive naturally since the chances of transmitting the virus are extremely low and very close to zero. He also suggested that the HIV-negative partner take HIV meds after exposure to further reduce the possibility of infection. What are your thoughts?

    Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum
    BODY SHAPE CHANGES & HIV/AIDS
     How Long Will It Take to Recover Lost Fat After a Med Switch?
    A year and a half ago, I switched an HIV med in my regimen in favor of Viread (tenofovir) to stop the progression of lipoatrophy. What can I do to reverse the effects of lipoatrophy more quickly?

    Nelson Vergel responds in the “Nutrition and Exercise” forum

     Do Any Body Shape Changes Develop From Taking PEP?
    I am currently on a 28-day course of Combivir (AZT/3TC) and Kaletra (lopinavir/ritonavir). Have there been any reported cases of lipoatrophy or lipodystrophy from taking this regimen as PEP (post-exposure prophylaxis)?

    Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum
    HIV/AIDS TREATMENT & SIDE EFFECTS
     Is Morning Lightheadedness a Side Effect of Atripla?
    I’ve been taking Atripla (efavirenz/tenofovir/FTC) for two months with no really bad side effects, except after waking up, I feel lightheaded. I have to sit for a few minutes before it goes away. What could be causing this, and what can I do?

    Keith Henry, M.D., responds in the “Managing Side Effects of HIV Treatment” forum

     Do-It-Yourself Dosing Changes: What’s the Risk?
    I’ve been taking Atripla (efavirenz/tenofovir/FTC) for close to two years and have had good success overall with the medication. However, it baffles me that a 400-pound guy would be on the same pill as a 150-pound guy. I’m concerned about the potential long-term effects these meds could have on my liver and kidneys. Is there an alternative dosage that maintains the ratio of the three meds in Atripla? Would there be any problem with splitting the pills and taking a half-dose on alternating days?

    Robert J. Frascino, M.D., responds in the “Fatigue and Anemia” forum

    More Questions About HIV/AIDS Treatment & Side Effects:

    Connect With Others My Partner Doesn’t Feel Sexual Anymore: Is It Me?
    (A recent post from the "Gay Men" board)

    I have been in a relationship for two years now. We’re both positive. However, he does not feel sexual. What could be going on? Has anyone else had a similar experience? Is it me? — 2cyclefun

    Click here to join this discussion, or to start your own!

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    OTHER HEALTH ISSUES & HIV/AIDS
     How Are Anal Lesions Screened and Treated?
    I’m 56 years old and I’ve been HIV positive for 25 years. In 2008 I was diagnosed with “intense dysplasia in the anal canal.” I get an anoscopy every year to follow up. What do you know about anal dysplasia? What else can be done to monitor or treat this condition? Is it likely to develop into anal cancer?

    Nelson Vergel responds in the “Nutrition and Exercise” forum

     Should I Worry About Getting a Cortisone Injection?
    I started Atripla (efavirenz/tenofovir/FTC) 10 days ago and have three weeks before my next blood draw. Due to a long-term running injury, my orthopedist suggested I get a cortisone injection in a bursa sac in my hip. I asked my HIV doctor about potential drug interactions; he said he didn’t have any “serious concerns” given that it was a one-time, localized injection, but he did tell me that steroids suppress the immune system, and that the cortisone could potentially affect my next lab test results. Do you have any thoughts?

    Nelson Vergel responds in the “Nutrition and Exercise” forum

     What Steps Can I Take to Lessen My Depression?
    Besides medication, what can be done to alleviate depression? Are there any alternative supplements I can take or activities I can do?

    David Fawcett, Ph.D., L.C.S.W., responds in the “Mental Health and HIV” forum
    UNDERSTANDING HIV/AIDS LABS
     Could My Perinatally Infected Child Be HIV Negative After All?
    My 9-year-old child contracted HIV from his birth mother. He was diagnosed at 10 weeks of age and started HIV meds immediately. By 14 weeks he had an undetectable viral load using ultrasensitive testing. He has never had a detectable viral load. He recently tested negative for HIV antibodies. He also experiences side effects from his HIV meds. I’ve asked his doctor if he can prove my son still has HIV. His doctor doesn’t know of a test that could do so. Do you know of such a test?

    Mark Holodniy, M.D., F.A.C.P., C.I.C., responds in the “Understanding Your Labs” forum
    HIV TRANSMISSION
     What Percent Risky Was My Behavior?
    I recently had sex with an HIV-positive guy. I was the top and did not use a condom. I know there’s some risk, but do you know the percentage? Does ejaculating inside the partner carry more risk than pulling out?

    Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

     Stories From the “Worried Well”: I Wasted 7 Years Worrying About HIV!
    It’s hard to remember when you’re wracked with fear that HIV is not the easiest virus to transmit, and that not every encounter will lead to HIV. Waiting seven years to get tested did nothing for me physically or mentally. For all you out there who are afraid to take that step, use my story as an example and don’t waste precious time. Get out there and know your status!

    Robert J. Frascino, M.D., responds in the “Safe Sex and HIV Prevention” forum

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