Answer provided by:

Mark H. Katz, M.D.
Regional HIV/AIDS Physician Coordinator
Kaiser Permanente of Southern California

Hello! I will answer your questions right next to each of them as you posed them:

In the middle of September I've been in Thailand and I get HIV from one lady. I am sure that that happened that time because I checked my blood every 3 months for HIV, because I play a lot of sports and I must to check my blood every 3 months.

Q. My therapy is: ZERIT, STOCRIN, and VIDEX, and I started one month and half before. My girlfriend has CD 4 cells level is 1000, and doctor said to her that she doesn't need to start with therapy for some time. Do you think that my therapy is good, and when my girlfriend must to start with therapy? - Your therapy is an acceptable regimen, used to be used commonly, but less so nowadays for at least 2 reasons: The combination of Zerit and Videx is associated with a higher incidence of neuropathy (tingling in extremities, sometimes impairing activity) than other regiemns. Also, Zerit is clearly associated with loss of facial fat, i.e. lipoatrophy. As for your girlfriend, it is impossible to predict, but most persons with HIV do not need therapy for at least several years, and some are not on treatment after more than 10. Just be sure her CD4 cells are followed, and when/if they get below 350, she is considered for medication.

Q. Which medication is better, Ziagen or Zerit? - They are comparable in potency, but must people today that I know of would prefer Ziagen because of the things mentioned about Zerit in the last question.

Q. How fast level of CD 4 cells can go up? They may go up rapidly, or slowly, or even not at all (in the latter case, a new regimen may be sought, except if the viral load goes to undetectable and the person feels fine). But the average shows that a year after treatment is instituted, you can expect a rise of 100-150 cells.

Q. If I have sex with girlfriend without condom (because we both have HIV), that can be problem or not? - It is always recommended that persons with HIV practice safe sex, and we know that around 3-4% of the time when they do not, one of the persons gets a new strain of the virus, a second strain, which may be harder to treat.

Q. Can she get baby without be infected with HIV, if she be pregnant with me? - There are techniques you would need to follow: You should have a procedure known as sperm washing, which decreases the possibility of passing on the virus, and she should be on antiviral therapy for most (some would say all) of her pregnancy.

Q. Can I use steroids, and if not, explain me why? - I am not sure what you mean by steroids. There is no major danger to any steroids to persons with HIV other than the same dangers to people in general--increased risks of diabetes, increased tendency towards certain infections. Nevertheless, people with HIV use steroids all the time, whether prescribed ot not.

Q. Why people with HIV after some time start to be skinny? - In later stages, HIV may interfere with absorption of food from the GI tract, and/or another infection may come in (e.g. diarrhea from a parasite) and this can cause weight loss. Some persons simply lose weight, without wanting to, and this is called wasting syndrome. There are treatments for this, too.

Q. Can I use medications for sleep, because I can not sleep so good and long? - Yes, speak to your doctor about these.

Q. If I use Viagra, can I have some problems (I still don't have problems,but I want to know, because I don't know what can be in future)? - Viagra has some interactions with certain HIV medications (the protease inhibitors, which you are not on. As of now, and with your current regimen, you should have no problem.

Q. Can I drink alcohol sometimes (beer or wine) and can I have some problem? - Absolutely, especially if in moderation, just like if you did not have HIV.

Q. Can I play sport like before (jogging, gym, and boxing)? - Absolutely!

Thank you for help. In my country doctors don't have so much time to speak with every patient about their problems. I am from Serbia and Montenegro.

Good luck!
Mark Katz, MD

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