So long, farewell
Hiv Forum | Questions About HIV and AIDS
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5y ago
They say all good things must come to an end.  I’m sad to announce that I’m shutting down the HIV Forum. In October I’ll be taking a new position as a senior director in Medical Affairs at Gilead Sciences.  I’ll be involved in medical and scientific education, both domestically and globally, and will be participating in Gilead’s continued HIV drug development. As a Gilead employee, it would be inappropriate for me to be providing answers to your questions—especially answers that might be misconstrued as medical advice. I’ve been conducting Q&A forums for more years than I can count: first ..read more
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Dr.Joel I have a question about Milk Thistle I have had no luck finding a answer to. Can you take it while taking genvoya?
Hiv Forum | Questions About HIV and AIDS
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5y ago
You can’t find an answer because the interaction has never been studied. There is the potential for interactions with drugs that use the liver’s cytochrome p450 enzyme system, which includes two of the components of Genvoya. On the one hand, I could tell you that it’s probably safe. On the other, hand, it might not be, and there are no proven medical benefits of milk thistle ..read more
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Can you you share some news from Paris conference you find exciting?
Hiv Forum | Questions About HIV and AIDS
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5y ago
I can do better than that: I can refer you to Paul Sax’s blog. He was clearly paying more attention than I was!http://blogs.jwatch.org/hiv-id-observations/index.php/really-rapid-review-paris-ias-2017/2017/07/30 ..read more
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So my boyfriend is HIV-positive, we've been dating for about 6 months now and I got tested for HIV after about 4 months and it came out negative. My boyfriend is undetectable and I'm currently working on getting PrEP. I was wondering because of the evidence from the PARTNER study, is PrEP really necessary for our situation? I mean I do like the mental reassurance that I'm safe not using a condom but what do you normally recommend for serodiscordant couples in this situation?
Hiv Forum | Questions About HIV and AIDS
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5y ago
I’ve answered this question many times in the past, but it’s been a while. Most experts consider PrEP “overkill” when an HIV+ partner has an undetectable viral load on ART, since there have been no reported cases of transmission in such relationships. I would recommend PrEP if you were having sex with other partners or if you weren’t certain of your partner’s adherence to therapy ..read more
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Can you recommend some good web resources for educated news and discussion on HIV and related ID developments? I follow Dr. Sax's blog, which is great. I follow you, but a lot of your questioners ask weird questions (not your fault!). I have an undergrad degree in biochem, but I am otherwise a lay person (a *gasp* lawyer, actually), I do not want to purchase access to professional journals, and the MSM-outlets and investor publications are a little thin on substance. What's out there for me?
Hiv Forum | Questions About HIV and AIDS
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5y ago
Here are just a few to get you started:Positively Aware:  https://www.positivelyaware.com/ HIV Insight at UCSF: http://hivinsite.ucsf.edu/Project Inform: https://www.projectinform.org/Clinical Care Options: https://www.clinicaloptions.com/hiv.aspxThe Body: http://www.thebody.com ..read more
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Hello chief, I read somewhere that because HIV patients infected with transmitted drug-resistance virus do not have a reservoir of drug-susceptible virus, drug-resistant virus is only replaced by drug-susceptible virus by "back-mutation", a process that can take years. What is "back-mutation"? Thank you!
Hiv Forum | Questions About HIV and AIDS
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5y ago
This means that the virus mutates “backwards,” from the transmitted mutant form to the “wild-type,” non-mutant version that circulates in the community. However, even with back-mutation, you should still  assume that some mutant virus persists in latent reservoirs ..read more
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I was switched from Truvada/Ticicay to Triumeq bc of low gfr in kidneys and there was no substantial change a year and a half after the switch. I recently saw a 15 point increase in gfr and the only change I made was stopping multivitamins. My question is to you: Can the multivitamins have been causing my low gfr?
Hiv Forum | Questions About HIV and AIDS
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5y ago
Multivitamins, taken at normal doses, would not affect kidney function or eGFR ..read more
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Dr G, my triglycerides are high and good/bad cholesterol out of whack. I mentioned The Intrepid and Reprieve studies and wondered if I should go on a statin and he said "oh, ID doctors don't do that. Your GP should prescribe that, I only monitor HIV levels. What is your feeling about an HIV specialist managing more than the virus?
Hiv Forum | Questions About HIV and AIDS
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5y ago
Some HIV specialists provide primary care for their patients, in which case this would be something they would do. Others provide only HIV care and leave primary care issues to the PCP. or GP.  If your HIV specialist believes that there’s no reason to be more aggressive with statins in HIV+ people than in the general population, then I can  see why he’d leave this to your GP. On the other hand, if he believes there’s a reason for more liberal use of statins based on HIV infection itself, then he would either prescribe the statins or communicate his recommendation to the GP ..read more
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Hi Joel, does being + increase the risk of having a UTI? I ask because for the last few weeks I have had a UTI and despite 4 seperate courses of antibiotics I've not been able to shift it. Thanks Mike.
Hiv Forum | Questions About HIV and AIDS
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5y ago
Mike, HIV doesn’t increase your risk of UTI, but UTIs are unusual in men. Maybe you’re treating the wrong condition. The more common infectious causes of urinary symptoms in men are urethritis (especially gonorrhea and chlamydia) or prostatitis ..read more
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You kindly ans'd my last ? on 6/30. I am the one the Doc has put on drug holiday. I'm now in month 4 of my labs coming back UD, and all other levels normal. I have tested Negative on 3 OTC antibody tests. I told my doc that you said "in isolation, a VL of 400 could be a false positive." He does not understand that. He says that once there is documented viral load, it cannot be a false positive. I am having an ELISA in 2 days. Do you have any language I can give my doc? DX 2013,..
Hiv Forum | Questions About HIV and AIDS
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5y ago
See link below: http://nccc.ucsf.edu/2016/06/24/case-of-the-month-false-positive-hiv-viral-loads ..read more
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