My Continued Journey Living With HIV

My Continued Journey Living With HIV

Hello everyone and welcome to my continued journey living with HIV.

As you may already be aware I switched medication from the once a day pill “ATRIPLA” to the once a day pill “TRIUMEQ” in late September 2014.

Well I am now embarking on yet another medication switch due to complications with severe weight gain after being on “TRIUMEQ”.

I am praying this new combination will give me relief from all the weight gaining so I can get back down to a comfortable weight. At present I have gained 40 pounds since starting on “TRIUMEQ”. Since this is unacceptable to me and to all my doctors, we decided it would be for the best to change medications.

I was very satisfied with “TRIUMEQ” – That was until I started gaining weight rapidly.

As of May 22^nd, 2015 I will be on the following combination:

TIVICAY® (dolutegravir) ‎ and TRUVADA® (emtricitabine and tenofovir disoproxil fumarate).

May 28^th 2015 at 10:15 am will be my 6 year anniversary since finding out I was HIV Positive. These few years of my life have had its ups and its downs, but I have managed to stay above water.

Yes, I may have many other health issues now, but I am learning to cope with them. I wish I could say it has been an easy journey, but then I would only be lying to myself. Whenever a person has a disease or virus that you must constantly stay on top of, it gets very tiresome and even lonely during the process.

I have been very blessed and thankful that the medications and health care changes I have made over the last few years, has actually boosted my immune system to a very high level. The last time I saw my ID Doctor my CD4 count was almost 3,000 {yes you saw that correctly} and I am completely undetectable.

I am blessed in deed that my body takes the medicine and does the job it was intended to do. I give thanks and praise to my creator {GOD} for the body that fights back!!!

Since my last update I have been in and out of the hospital with massive kidney stones that had to be blasted. My kidneys have been working overtime to fight off all the toxic medications. I thank God that they still function, even as they have begun to form lots of cysts and still producing stones at this writing. I pray one day they will be made whole again. I have also developed Diabetes and more Heart issues. I refuse to let these new health issues bring me down. With hard work and good medical care I know I will make it through this rough patch.

I pray that all who keep up with me know that the road on this journey may not always be roses but it is a journey/fight that is still on the right track.

Now if I could get the insomnia under control, I will be on the road to a more rapid recovery. Remember my friends that you may HIV – BUT HIV does NOT have to have you!! That is one phrase that I like to keep repeating to myself every day, so my body knows that I have not given up on it!!

I pray that all who are going through this journey of living with HIV, will be blessed and have the peace that passes all understanding that can only come when you allow God to take the wheel.

Stay tuned – More to come from my journey living with HIV!!

Best Ways to Battle HIV Fatigue

Discover the best ways to beat HIV fatigue.

Part 1 of 8: Overview

Understanding Fatigue

Out of the many possible symptoms of human immunodeficiency virus (HIV) infection, fatigue is one that can have a subtle yet profound effect on your quality of life. The nagging feeling of low energy can keep you from socializing, exercising, and even carrying out the basic functions of everyday life. However, there are ways to battle HIV fatigue and reclaim some of that lost energy. One of the keys is to understand the causes of your fatigue. From there you can start to treat your problem. While you may not be able to completely eliminate HIV-associated fatigue, you can learn to minimize its frequency and its impact on your life.

Part 2 of 8: About HIV

About HIV

Unlike other viruses, such as those that cause the flu, HIV targets your immune system, which results in your immune system being unable to get rid of HIV. HIV is a disease that is transmitted through contact with bodily fluids. There is no cure, but there are many medications that can help keep HIV from progressing to acquired immunodeficiency syndrome (AIDS). Because HIV attacks the cells that help fight disease, HIV-positive people are especially vulnerable to other viruses and diseases caused by bacteria and fungi.

Part 3 of 8: Fatigue Signs

Signs of Fatigue

Along with a headache, fever, swollen lymph glands, and a sore throat, fatigue is one of the early symptoms of HIV. These signs may vanish after a while. In some cases, people with HIV may believe their symptoms are related to a common flu virus. HIV can also be present without any symptoms appearing for several years. 

People infected with HIV experience fatigue for many reasons.  The simple presence of the infection can contribute to fatigue as the body uses energy trying to fight the infection. The virus also “steals” energy from cells to allow it to reproduce.  Some of the many other reasons for HIV-associated fatigue include anxiety and depression, sleep problems, pain, and other coincident infections/illnesses. Unfortunately, fatigue is also a very common side effect of many HIV medications. There are proven solutions, however.

Part 4 of 8: Depression

Depression and Fatigue

Depression can often accompany a serious disease such as HIV.  Feelings of hopelessness and sadness can leave a person drained of energy. Depressive symptoms include feelings of sadness or anger, a withdrawal from friends and activities you once enjoyed, and engaging in risky behaviors. Depression can also interfere with eating and sleeping patterns. Depressed people are often less likely to exercise, which in turn, can leave them feeling even more fatigued. 

If you have HIV and are starting to develop symptoms of depression, you should speak to your doctor or a mental health professional. You may be able to overcome your depression with talk therapy and other means that don’t include medications, such as antidepressants. You may also find that alternative therapies, like meditation or yoga, help with depression. 

A study in the journal Psychosomatics found that treatment with the medication armodafinil was able to help improve mood and overcome fatigue in certain HIV patients. Armodafinil changes the amounts of certain substances in your brain. The drug is typically used to treat sleepiness in narcolepsy.

Part 5 of 8: Insomnia

Overcoming Insomnia

Insomnia is a condition that means you have difficulty falling asleep or difficulty staying asleep. In either case, a poor night’s sleep can leave you dragging the next day. To help battle insomnia, remember a few key tips:

• Try to go sleep and rise at the same times every day.
• Keep a log of how you sleep so you can note changes in your sleeping patterns.
• Don’t lie in bed awake and anxious. If you’re unable to sleep, move to a different part of your home. Rest until you feel tired enough to try sleeping in your bed again.
• Try reading. Don’t watch TV or get on your phone or computer.
• Avoid alcohol right before bed and caffeine late in the afternoon or evening.
• Keep your room dark and cool, if possible, to create a sleep-friendly environment.

If you’re still having difficulty sleeping after trying these recommendations, speak with your doctor. They may recommend a sedative or hypnotic medication.

Part 6 of 8: Drug Reactions

Drug Reactions

HIV medications are powerful drugs, and not everyone reacts the same way to the same combination medications. If you find yourself feeling fatigued after starting a new drug regimen, tell your healthcare provider. Trying a different drug or combination of HIV drugs may help. However, it’s important to note that changing antiretroviral regimens is a serious undertaking. Changing regimens can increase your risk for developing a resistance to antiretroviral drugs. It’s also important to note that you should not stop taking your  medication without discussing it with your doctor. Pausing antiretroviral medication can also open you up to drug resistance.

If you experience declining health, your medication needs may change. Growing feelings of fatigue may be due to changes in our drug regimen or to medical problems beyond your control. It’s up to you, however, to tell your doctor how you’re feeling and to ask if there are solutions to your feelings of decreased energy.

Part 7 of 8: Unexplained Fatigue

Idiopathic HIV Fatigue

When the source of your fatigue can’t be directly linked to depression, insomnia, drug reactions, or other specific causes, it’s said to be idiopathic HIV fatigue. Idiopathic is a medical term that means the cause of a condition is unknown. 

Idiopathic HIV fatigue is common, but it’s hard to predict. You may experience it at any point in the day, and you may go days without having those tired feelings. The use of stimulants such as methylphenidate (Ritalin) and dextroamphetamine (Dexedrine) may be helpful. Your doctor may prescribe them for use every day or just when you start to notice fatigue setting in. If you have a history of abusing stimulants, your doctor may look for other solutions.

Part 8 of 8: Finding Answers

Don’t Give Up

HIV is a chronic disease, but with careful medication use and healthy habits, it can be a manageable condition. Fatigue is a problem facing many people, including those with and without HIV. However, there are a host of therapies and behaviors that can help. For many people, exercise can give your mood and body a boost. Maybe starting your day with a brisk walk can give you the lift you need to shake off that fatigue and approach the day with improved vigor.

Find more information about living with HIV here: http://www.healthline.com/health/hiv-aids

STUDY: Molecule Discovered That Makes HIV Vulnerable to Attacks

Researchers have discovered a molecule that renders HIV vulnerable to immune system attacks. Could it lead to a vaccine?  

BY JACOB ANDERSON-MINSHALL

MAY 12 2015  

Researchers have discovered a molecule that renders HIV vulnerable to immune system attacks and could help eliminate HIV reservoirs or be part of a vaccine.

The  JP-III-48 molecule mimics a type of protein and appears to trick HIV into opening itself up to attack from antibodies that could kill the virus.

Medical News Today has reported that researchers at the Centre hospitalier de l'Université de Montréal

(CHUM) Research Centre in Canada found that molecule, which they dubbed a "can opener," forces the HIV-1 virus to open and exposes it to attack.  HIV-1 is the most common strain of the virus.

The researchers also discovered that people infected with the HIV-1 virus usually have naturally occurring antibodies that could kill the HIV-infected cells once they are exposed.

"We just have to give them a little push,” reported the study’s author, Dr. Andrés Finzi in a written statement. “Adding a tiny molecule that acts as a can opener [forces] the viral envelope to expose regions recognized by the antibodies, which forms a bridge with some cells of the immune system, initiating the attack."

The study, published in Proceedings of the National Academy of Science, builds on previous findings this year; that cells infected with HIV-1 were more easily eliminated when two HIV-specific proteins (Nef and Vpu) were deactivated.

Because these two proteins protect the HIV virus from attack, eliminating or deactivating them could leave the virus vulnerable and exposed.

The JP-III-48 molecule imitates the CD4 protein, a protein that makes T lymphocytes, a type of white blood cells vulnerable to HIV infection. For the new study, the Canadian team added the CD4 protein-mimicking molecule to the surfaces of infected cells and found that it tricked the HIV virus into making itself vulnerable.

"The virus has to get rid of the CD4 proteins to protect itself,” explained Jonathan Richard, a postdoctoral researcher at CHUM who participated in the study.

Mistaking JP-III-48 for CD4, the HIV-1 virus opens, exposing vulnerable elements that become a target for antibodies.

“Adding the small molecule forces the viral envelope to open, like a flower,” Richard added. “The antibodies that are naturally present after the infection can then target the infected cells so they are killed by the immune system."

This ability of the molecule to trick HIV infected cells into opening up to attack could have far reaching ramifications including eliminating HIV reservoirs

"The solution is to develop a 'shock and kill' therapy,” Finzi explained. “We have to reactivate HIV reservoirs to force the virus out of its hiding place, then kill the infected cells with this molecule and the already present antibodies."

Globally, around 35 million people are infected with HIV-1 and could be helped by this discovery. In addition to eliminating reservoirs, the JP-III-48 molecule may also lead to the development of a vaccine, which would combine the molecule and HIV antibodies to target the virus with a one-two punch.

The JP-III-48 molecule was previously developed by researchers from Harvard University and the University of Pennsylvania, but this is the first study using it as a potential HIV treatment.  

The next step for the Canadian team is to assess JP-III-48 capabilities in tests involving monkeys infected with the HIV-like simian virus.

You can find more articles like this here: http://www.hivplusmag.com/

Good Communication Strategies to Make HIV Care Click

By Martha KempnerFrom TheBody.com

May 1, 2015

Some of our most important relationships, and some of the most difficult to navigate, are the ones we have with our health care providers. Finding the right balance between respecting their opinions and questioning their advice can be hard. We can feel reluctant to tell them the truth for fear of being embarrassed or judged -- or in the case of HIV, leaving a record that could even be held against us in the unlikely event of criminalization. And, too often, we feel so rushed through the entire encounter that we leave more confused than when we arrived. Being able to hold open, honest conversations with your providers is vital to good health. That's why it is important to feel at ease with your providers, and to feel that you can trust them -- even in discussions that can make either or both of you uneasy.
Here are some tips toward building a comfortable and healthy relationship with your provider.

Find a Provider You Click With

Though we usually choose our health care providers based on their expertise, location and whether they accept our insurance, the most important factor is often their personalities and bedside manners -- all of which can be impossible to know before the first visit.
Consider that initial visit a trial run, and notice your first impressions. As the appointment proceeds, take mental notes on the provider's style. Some are laid back and treat you like a pal, while others are more formal. Some are used to being the last word on every health subject and speaking definitively; others are more open to discussing options with you and plotting a course together.
Ask yourself: What are your first impressions? Do you feel comfortable discussing personal issues like sex or depression? Do you feel like you could ask questions or challenge professional opinions? Do you feel judged? If you are LGBT, how does the provider react when you bring that up, both in verbal reaction and body language?
Take note of things outside the room as well. Was the front office staff friendly? Did they keep you waiting too long? Was there a waiting room full of people making you and the provider feel rushed? How can you contact your provider between appointments? Will you have direct communication, either through voice mail, email or an electronic medical records site, or do you have to go through office staff first?
While these may seem like trivial details, they can become very frustrating in the long run. It is not absurd to switch providers simply because the office staff is nasty, appointments are impossible to get, or no one ever calls you back to answer questions.
Trust your gut to decide whether this is a provider and an office you want to get into a long-term relationship with. Though health insurance or geographic issues may limit your choices of clinics or practices, there may be other options such as a different provider at the same clinic. Remember, providers may be the experts, but you are the customer.
Mark S. King made a practical and entertaining video showing how he went about finding "Doctor Right" that can help you in your quest.

Plan Ahead

Office visits are not very long and much of that time is spent being poked and prodded. It can be easy to walk out without asking the one question that's been on your mind for months. The best way to prevent regret is to plan ahead. Make yourself a list including the questions and concerns you have as well as the things you want to make sure your provider knows (see the "Telling the Truth" section below). And don't censor yourself out of a fear of looking foolish -- your headaches probably aren't brain tumors, but telling your provider that the thought has crossed your mind can both help determine what is really going on and put you at ease as well.
A list is also a good way to extend the visit if you feel rushed or sense that the provider is trying to get out of the room. Saying, "I know this visit is getting a little long but I have just three more things on my list to discuss with you," can be a good way to set parameters and get what you need.

Telling the Truth

Whether they are trying to diagnose a new problem or manage your existing condition, health care providers are relying on the information you give them. But sometimes it's hard to give them the full story because of embarrassment or a fear of judgment. You may not want to admit that you didn't follow the advice you got at the last visit. Maybe you haven't quit smoking, changed your eating habits, or taken your medication exactly as prescribed. Revealing this can make you feel like a child being sent to the principal's office -- but keeping it to yourself can have negative repercussions on your care. Try to remember that you're an adult and, though it may feel this way, health care providers should not be the behavior police. Go ahead and tell the truth.
It can be intimidating to share details of your life, especially when those details include typically taboo topics like the number of sexual partners you have, interpersonal violence or drug use. Most providers have heard it all before and should take it in stride. (If your provider doesn't and you really do feel judged, consider a switch because this attitude can get in the way of an honest relationship and good care.)
It can be particularly hard to discuss mental health and relationship issues, but again, this information is important to your overall health. Depression and anxiety, for example, can be the cause behind physical symptoms. They can be treated but only if your provider is aware of them. Relationship issues such as interpersonal violence are also relevant to your care as they can put you at risk for reinfection, other STDs or injuries.
If you have a history of trauma that can make medical exams difficult, it can help to let your provider know that you have experienced past or recent trauma. The National Council for Community Behavioral Healthcare suggests you let providers know what's helpful to you, such as requesting that they ask permission to do a procedure, keeping as many of your clothes on as possible, or having a supporter with you in the room.
It may be easier to bring up these sensitive topics when health care providers ask the right questions, and many will -- especially those who specialize in patients living with HIV. Unfortunately, some doctors are just as reluctant to bring up uncomfortable subjects as their patients. Others are too rushed to remember. Ultimately, it is up to you to make sure your health care provider is operating on full information. Again, try writing down a list of things you want to share ahead of time to make sure you don't forget.

Considering Criminalization

When it comes to HIV, it's important to be aware of your -- and your health care provider's -- legal obligations under HIV criminalization laws and policies without letting those get in the way of your health care and your patient-provider relationship. Most states have laws or regulations that require people with HIV to disclose their HIV status to sex partners (even if condoms or low viral load means there's a low-to-incredibly-low risk) or face specific legal charges. If you don't know what your state or territory's HIV-specific laws are, learn about them. Although the chance that you will be involved in an HIV criminalization case is extremely low, it is highly likely that your medical providers will be asked to testify if you find yourself being prosecuted.
There are a few steps you can take to ensure that you share information with your provider in a safe and mutually beneficial way. You can ask your provider to document in your medical records that you have disclosed your status to sex partners. Some people have even brought their HIV-negative partners to the doctor with them to have the conversation recorded in person, which is also an opportunity for their partners to get prevention questions answered. And if your viral load is undetectable, your provider can also document that you have had a conversation about what that means for HIV prevention.
You can also talk with your providers about whether or not they need to document any conversations about your drug use or sexual behavior. There are a number of guidelines about this, including one fornurses in Canada and another for clinical providers in the U.K. that may help facilitate this conversation.
"It is usually suggested that records around risk and disclosure are kept to minimum, and that recording nondisclosure and lots of risk-taking is not necessary," says Edwin J. Bernard, coordinator of the U.K.-based HIV Justice network, "whereas recording that disclosure has taken place, and that clinician information regarding effectiveness of undetectable viral load on HIV prevention has taken place, is a good idea."
It is up to you whether you obtain safer sex support from your medical provider. Discussing these issues with community-based or peer counselors may be easier. At times, some providers may have a different approach or agenda based on public health priorities (preventing new infections), rather than individual support (promoting your sexual health).

Ask Questions, Speak Up and Bring a Friend

Sometimes it can be hard to absorb everything our health care providers are telling us. They may talk too fast or use too much medical jargon -- or they might just have a lot of information to offer. Don't worry if you don't understand it all the first time. You are well within your rights to ask them to go back, say it again, or explain it differently. It is OK to say "I don't understand." That doesn't make you stupid and it doesn't mean you're a difficult patient.
It's also OK to question the information they've given you. Medicine is not an exact science and health care providers don't all have the same opinions about the best course of action. If something your provider says contradicts advice you've gotten from another health care provider or doesn't jibe with what your partner's provider suggested, ask for clarification. And if you aren't comfortable with the advice your provider gives, based on past experience or things you've read, speak up. It's better to give your provider the chance to explain than to try to sort it all out with information you find on the Internet when you get home. It is also better to tell your doctor that you disagree than to leave the office under the assumption that you're satisfied when you really have no intention of following the advice.
Advocating for ourselves can be tricky especially when we're still trying to absorb information. Consider bringing a partner, friend or family member who you feel comfortable with to your appointment. Another set of ears often helps, and your companion may have an easier time saying "Wait, I don't understand" or "Are you sure that's the very best course of action?" than you do.
We can't promise that these pieces of advice will guarantee a relationship free of awkward moments. But we do think that this can set the stage for an honest relationship with someone whose job it is to help manage your health.
Martha Kempner is a freelance writer, consultant and sexual health expert.
Follow Martha on Twitter: @marthakempner.

Copyright © 2015 Remedy Health Media, LLC. All rights reserved.

Find more articles like this here: http://www.thebody.com/

Another Reason to Stay on Your Medication

One of the goals of HIV service providers is to connect patients with care as quickly as possible, especially since early treatment has been shown to provide long-term advantages. But a new French study reports that any immune recovery benefits gained by starting antiretroviral medications early may be lost if treatment is later interrupted.

 

BY JACOB ANDERSON-MINSHALL April 16, 2015
 One of the goals of HIV service providers is to connect patients with care as quickly as possible, especially since early treatment has been shown to provide long-term advantages. But a new French study reports that any immune recovery benefits gained by starting antiretroviral medications may be lost if treatment is later interrupted.

In fact, the study found little or no difference (in terms of immune reconstitution) between those who had started treatment immediately and later stopped for a time and those who didn’t start treatment until their CD4 counts fell below a certain figure.

The findings, published in the journal AIDS, suggest that only combining early treatment with continuous lifetime adherence gives patients the best hope of reaching a near-normal CD4 to CD8 ratio.

CD4 cells, also known as “T-helper” cells, play a key role in launching the body’s immune response to an infection. In contrast, CD8 cells, or “T-suppressor” cells help kill off infected cells. Healthy HIV-negative people tend to have more CD4s than CD8s, meaning their CD4 to CD8 ratio is greater than 1.0; but those with HIV typically have ratios below 1.0. 

The study looked at HIV-positive people who were part of the PRIMO cohort study and were receiving treatment at the time. The patients in the study fell into three groups:

• Thirty-four percent (244 individuals) started treatment within two months after infection. More than half of those had only one treatment interruption while 47 percent experienced more than one interruption.
• Thirty percent (218 people) did not start taking antiretroviral medications until an average of about two and a half years after infection.
• Thirty-six percent (265 people) started treatment shortly after contracting HIV and remained on ARV treatment continuously.

The study found that those who began ARV treatment quickly and remained on it continuously had an average CD4 count of 731 cells: 125 cells higher than those in the deferred treatment group and 106 cells higher than those who started treatment early only to interrupt it later.

Those who received early care and did not stop taking ARV medications also had higher CD4 to CD8 ratios than those in either of the two other groups. A full 64 percent of the early and continuously treated patients achieved a ratio greater than 1.0, compared with just 40 percent in the deferred group and 36 percent in the treatment interruption group. These results were true even after controlling for things like treatment duration, sex, and age.

AIDSMap reports, “while most people prescribed ART eventually develop a near-normal CD4 count, only those who started treatment soon after infection, who have continued it ever since and remained undetectable stand a more-than-even chance of achieving an immune system where the balance of T-lymphocytes resembles that of a person without HIV in terms of their CD4:CD8 ratio.”

The study’s researchers conclude, “Our results underline the critical need in early-treated patients to maintain adherence, in order to limit cumulative HIV viremia [presence of the virus in the blood] and optimize immunological recovery, notably the CD4+/CD8+ ratio.” 

But this does not mean that there is no point in starting treatment early, or in returning to treatment after a gap in adherence. While continuous treatment is better, this study’s findings reiterate that antiretroviral treatment is critical to achiving a healthy immune system when poz.
 
Read More ArticlES like this one here: http://www.hivplusmag.com/