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Medical Marijuana? An editorial in the January 30th 1997 issuse of the New England Journal of Medicine stated that marijuana can have positive benefits for PLWHIV. Primarily used as an appetite enhancer, marijuana can be helpful in fighting wasting, the process of weight loss often resulting in dealth. The editorial stated that many find the herb more effective than its synthetic cousin Marinol. This editorial reflects the experience of many people living with HIV who report benefit in combatting wasting and to alleviate pain. Richard Gottfried, chair of the NYS Assembly Health committee, has introduced a bill calling for allowing the use of marijuana under the supervision of a licensed health professional. As with any medication there may be side-effects. Generally they are mild and short-term. There is no known toxicity level with marijuana, and unlike Marinol, physical dependency has never been established. Related article

For Women Only: According to the statistics cervical cancer affects less than one precent of people with HIV. This statistic is deceptive because it includes all people with HIV. Men, whether positive or negative, don't get cervical cancer. So what are the real risk for women living with HIV? A number of studies, in the U.S. Europe and Africa, have shown that women with HIV are approximately three times more likely to be infected wiht human papillomavirus (HPV), the probable cause of cervical cancer. It has also been demostrated that HIV+ women are twice as likely to have cervical abnormalaties. Thus women with HIV have a higher risk for development of cervical disease. This is important to be aware of because cervical cancer can be fatal. Many experts recommend HIV+ females have a pap smear every six months. Often doctors will also perform a colposcopy, which is more accurate than a pap smear. Several studies have noted cervical abnormalities were found with colposcopy in women with no rmal pap smear results. To reduce the possibility of a false pap smear result it is recommended to have the smear when you are off your menses, and to put nothing in your vagina for 24 hours prior to the exam. That means no penetrative sex (fing ers, toys, whatever), and no douching or tampons. There are a nember of ways to treat cervical disease, the key is early detection.
Feeling Blue? Depression is common in PWHIV. There are many causes of depression including: fear, biochemical changes, nutrient deficits, social forces, and low testosterone in males. Depression can have a negative effect on many aspects of our lives. But this need not be. There are effective ways of addressing depression in most cases. Some people benefit from support groups, others from specific medical or nutritional intervention. The important thing is NOT to accept depression as a way of life. Reach out to a friend or your healthcare provider.

New Kid on the Block: There is a new class of antiretroviral medication called Non-Nucleoside Reverse Transpcriptase Inhibitors (NNRTIs). The two most tested are Nevirapine (which has received FDA approval) and Delaverdine (which is not yet FDA approved but is available through an expanded access program). Though chemically different from nucleoside analogs like AZT, they act in a similar manner blocking the production of reverse transcriptase (a crucial enzyme HIV needs in order to co-opt a cell's DNA and make the cell into an HIV "factory"). Early trials demostrated that when used alone viral resistance developed in two to seven weeks from start of therapy. Recent studies indicate that this is not a problem when used in combination with one or more of the nucleoside analogs. One study using a combination of Nevirapine, AZT, and ddI de! mostrated a 2 log (100 fold) drop in viral load within one month. Furthermore, the majority of trial participants showed no signs of resistance in the 10 months the study took place. This is encouraging news, particularly for people who either cannot tolerate, find little benefit from, or have become resistance to protease inhibitors.

Protecting your Eyes and Kidneys: CMV is a virus in the herpes family that can affect any part of your body. Most often it attacks the eyes and is known as CMV Retinitis. Early detection and treatment of CMV Retinitis can save your vision. Some early warning signs of CMV Retinitis are: floaters (patches of light that seem to "float" in the air), flashers (brief flashes of light), and distortion or blind spots in your field of vision. If you are expriencing any of these symptoms please see your doctor immediately. But don't wait for warning signs to appear before you get a screening. It is recommended that any one with a T-cell count of under 100 have CMV Retinitis Screening done on a regular basis. The exam is quick and painless. The earlier CMV is detected the more effective the treatment. Clinical trials of treatments for CMV retinitis.

Warning: concerning Cidofovir (brand name - Vistide) Recent reports indicate the need for close monitoring of people using this anti-CMV medication because of the possibility of severe kidney damage. Your doctor should do blood tests for kidney functioning before and 48 hours after treatment with Cidofovir begins. If serum creatinine level rises more than 0.3 to 0.4mg/dl over your pretreatment reading, or if 2+ proteinuria occurs, this indicates the need for dose reduction. If serum creatinine level rises over 0.5mg/dl, or 3+ proteinuria occurs, cidofovir should be discontinued. Cidofovir should not be used in conjunction with other medicines known to be toxic to the kidneys. Studies indicate Cidofovir to be effective in the treatment of CMV Retinitis, however it is crucial for your doctor to closely monitor your kidney functioning while using this medication.

Report on Vitamin B12 & Vitamin E: Two recent studies, one from Johns Hopkins University and the other from Janeway Child Health Care Centre in Canada, indicated that low levels of vitamin B12 and E are associated with more rapid progression of HIV disease. Dr. Tang of Johns Hopkins found an 89‰ increase in risk of disease progression in men with low levels of B12 as opposed to those with appropriate levels. She also noted that men with high levels of vitamin E had a 33% decrease in the risk of disease progression. She has demostrated that vitamin E supplementation results in raising the level of the vitamin in the blood. Additional research is needed to demostrate if supplementation with B12 will result in increased B12 in the blood. Dr. Tang believes more research is needed to further demostrate the connection between disease progression and deficits in vitamins E, B12, and also vitamins A and B6.

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