Anonymous Asked
QuestionHello I'm very confused right now. Let me explain. I just got surgery for acute severe appendectomy. During blood work and testing they screened me for HIV and I came back positive. They did more tests and now my case is closed. Here are the results written in the paper: HIV RESULTS PROCEDURE HIV1 AB NON REACTIVE F HIV2 AB NON REACTIVE F HIV 1/2 NOTE COMMENT F TEST PERFORMED 13112 evening creek dr so ste 200 SAN DIEGO, CA CLOSED, RESULTED so I'm I positive or negative? Please help Answer

"Non-reactive" means negative.  Case closed.

Anonymous Asked
QuestionHello dr, I have tried to tolerate tivicay and epzicom since everyone and doctors say it's the most well tolerated medication right now, but for some reason I keep having fever, sweats, headaches and insomnia for the last several months on this regimen. In the past I've also tried stribild, but it didn't work out for me. In your opinion what is the next well tolerated combo with little side effects and none wasting therapy you prescribed to your patient's that's senseative to side effects. Answer

The problems you’re having don’t sound at all like drug side effects; they sound like symptoms that should be evaluated by your doctor.  If someone comes to me with fever, sweats, headaches, and insomnia, a drug reaction would be very low on my list of causes.

Anonymous Asked
QuestionHello. I am an HIV positive guy,in a relationship with an hiv negative man. I have been undetectable for 3 years. We never have unprotected sex and i am always the bottom. Last week we had sex (me being the bottom again) but his condom broke. He sais he felt when it broke and he couldn't have stayed for more than 10 seconds inside me,bare. Please tell me what are the risks of getting him infected this way? I am desperate. I don't think i could ever forgive myself if something would happen. Answer

Between your undetectable viral load and his being on top, the risk of transmission is infinitessimaly small.  You shouldn’t be worried.

Anonymous Asked
QuestionMy eye doctor asked if I take any medications as part if my routine exam, I have not started my meds. Do I have to disclose to my eye doctor when I start meds? Answer

Do you have to?  No

Should you? Yes. Doctors can take better care of you if they know your medical history and what medications you’re taking.

Anonymous Asked
QuestionOk, I'm a little confused. Are vitekta and tybost an combined booster used with prezista or other drugs that need boosting, or you can either use vitekta or tybost as a stand alone booster and not together. Help me doc my mind is bad. Answer

Tybost is a booster; Vitetka is an integrase inhibitor. You can use either Tybost or Norvir (but not both) to boost Prezista, Reyataz, and other protease inhibitors.   Vitetka is not a booster; it needs boosting. You can use Tybost to boost Vitetka too.

Anonymous Asked
QuestionHere we are, those of us who thought we'd be long gone but healthy on meds and pushing 60. (60!) So, what is the recommendation regarding the shingles vaccine for us? Answer

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The guidelines say that you should “consider” shingles vaccine if you’re over 60 and have a CD4 count over 200. I’d go a little further and would recommend it.

Anonymous Asked
QuestionSince the fda has approved tybost, in the near future does that mean you have the option to take tybost, prezista, with either truvada or epzicom? Will the possible side effects lessen with the combination then taking with norvir. Answer

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Yes, you’ll have that option right away.  If you’re having side effects from Norvir, switching to Tybost might help. However, the tolerability of Tybost has been similar to that of Norvir in clinical trials—its main advantage is that it will be coformulated with other drugs.

Anonymous Asked
QuestionHi Doctor! I wrote you two weeks ago and you were incredibly helpful! I was diagnosed a month ago. My counts are CD4 85 VL 20000. I've been taking Bactrim daily and Zitromax every Sunday for two weeks. I started Stribild today. Here is the thing: starting two days ago, for three consecutive days as of now, I got a clockwork fever every day starting at 6-7pm, taking me from 98F to 102/4F by 9pm ... and by 11pm temperature is normal and I'm feeling like a rockstar. Answer

See continuation below.

Anonymous Asked
QuestionI'm puzzled. Never heard of anything like this. My doctor thinks I may be allergic to Bactrim, but I took the Bactrim at different times every day (4pm, 2pm, 10am). And the fever still came at 6-7pm, every day. No other daily pattern of any kind from my side: everyday I did everything at different times (eating, showering, etc). No job. Only left the house to go to the pharmacy to get the prescription filled. The prior time I had a fever was years ago. Any words of wisdom? Answer

You could have a drug fever from Bactrim.  The timing of the fever with respect to the dose doesn’t really matter.  One of the common features of drug fever is that you tend to feel “inappropriately well” despite having a fever, and that your heart rate doesn’t increase as much as it would if you had a fever due to infection.  (With infection, you should have a heart rate of at least 110 with a fever to 102; with drug fever it’s often lower.)

The easiest way to find out whether Bactrim is the cause is to stop taking it for a while. If you have a drug fever, the fever will go away quickly. If it doesn’t, then you need to be evaluated for other causes of fever.

A short interruption of your PCP prophylaxis shouldn’t be dangerous since you’re now on antiretroviral therapy.  However, there are alternative forms of prophylaxis if you can’t take Bactrim, including dapsone and atovaquone. Talk to your doctor about this.

mirywi Asked
QuestionTYBOST is by far the worst HIV drug name ever. Who comes up with these? Answer

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It is a strange name, I agree, but my guess is that Tybost will be like Emtriva.  Emtriva is the brand name for emtricitabine (FTC), a widely used drug, but almost always taken as part of a combination pill (Truvada, Atripla, Complera, or Stribild).  Few people take emtricitabine in the form of Emtriva. Similarly, cobicistat will be used mostly in Stribild and in pills that combine it with Prezista or Reyataz. leaving few people on Tybost. If you really hate the name, you can take some comfort in that.