Women & HIV. What Are The Challenges Women Face on Treatment?

After more than 25 years and 25 million deaths, the world has yet to realize that HIV isn't just a man's problem. HIV has quietly become the third most-deadly disease for women, after heart disease and cancer. The single most significant fact that separates female PHA’s from male PHA’s is that more than 60% of women are caring for at least one child under the age of 16. Female PHA’s are also different from male PHA’s physically, psychosocially and emotionally. There is now information that states female PHA’s develop AIDS at a lower viral load than men, and in fact at a viral load below the recommended level for treatment with HAART, which makes it extremely important to treat early. The most noticeable side effects from HAART have been metabolic -- the so-called fat-redistribution syndromes, which in a woman translates to significantly enlarged breasts and abdomen. Menstrual irregularities, like amenorrhea (no menstrual periods), polymenorrhea (periods come too often) and oligomenorrhea (periods don't come often enough). Sexual function changes: decreased sexual interest, delayed or difficult orgasm. Obese women over 40 are more likely to develop lactic acidosis, which has been linked to mitochondrial toxicity due to reverse transcriptase inhibitors. Have you experienced similar or different side effects? Tell us your thoughts.

Human Growth Hormones + HIV Meds = Healthier Living?

Human growth hormone could reduce fat deposits caused by HIV treatment. Low doses of human growth hormone can reverse some of the abnormal fat distribution and lower the risk of cardiovascular disease, caused by HIV treatment. 40% of males and 16% of females who take antiretroviral drugs develop visceral fat in the stomach, neck and cheeks, which is associated with higher levels of cholesterol and triglycerides and can increase the risk of heart attacks and stroke. A Harvard Medical School doctor said the hormone produced good results but would have to be used carefully to avoid inducing diabetes. The hormone could increase the risk of side effects in people who have early stages of diabetes. Previous studies using higher levels of the hormone produced "unacceptable" side effects, including tissue swelling and joint pain. Another AIDS expert suggested that although there were fewer side effects with lower doses, the results of the study were "disappointing" and states hormone injections at best have limited use for treating fat abnormalities associated with HIV. Can this be the threshold for more positive results toward healthier living with HAART? What are your thoughts?

Have we won the AIDS battle? Are the years of fighting over?

Doctors have presented information which may end the painful years we know as AIDS. New HIV treatment guidelines issued at the International AIDS Conference in Mexico urge starting ARV therapy sooner. The goal is to achieve maximum suppression of the HIV/AIDS virus, with minimal toxicity, and maximum simplicity. Initiation of ARV therapy in PHA’s within the 200 to 350 CD4 cell count range should be strongly considered. Recommendations? Start ARV therapy in PHA’s that have less than 200 CD4 cell count. Doctors are encouraged to evaluate the whole patient, not just the status of HIV disease, but all coexisting conditions. What are the key areas of ARV management? When to start therapy, choice of HAART regimen, PHA monitoring and how best to approach treatment options. The hope is that the AIDS virus will be completely contained as ‘undetectable’ in the body of the PHA. Is it that simple? Can we finally conquer the AIDS virus? What are your thoughts?

Hep C and HIV coinfection in B.C. Is it out of control? An epidemic?

Hepatitis C and HIV coinfection is a reality growing out of control in British Columbia. Hep C (HCV) makes the HIV disease worse. HCV is transmitted through infected blood. HCV damages the liver. About 15% to 30% of people clear HCV from their bodies without treatment. The other 70% to 85% develop chronic infection, and the virus stays in their body unless it is successfully treated. For PHA’s, HCV can be more serious and make it harder to take ARVs. HCV and HIV coinfection slows down the rate of increase in CD4 cell counts during HIV treatment. A doctor who treats patients with HCV is criticizing the B.C. government for denying lifesaving treatment in what he terms a full-blown epidemic. “At best, I can say it is indifference to an epidemic of huge proportion. It is one of the most serious epidemics we are facing in our community today." B.C. Health Minister George Abbott disagrees. "I don't think its fair to say it's an epidemic," Abbott said. "Certainly Hep C is a very big challenge — that is why we are expending about $100 million annually in identifying preventing and treating Hep C when it occurs." Do you think B.C. is doing enough? Should we do more? What are your thoughts?