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Meds Question
Aug 11, 2007

Hi Doc:

I contracted HIV 9.5 years ago from heterosexual intercourse with my current boyfriend (I guess when you've been together for almost a decade, he's probably more than my boyfriend, but.. oh well). I became pregnant early on and was placed on Combivir and my blood work was monitored heavily. Thankfully, my son is fine. When I was on the Combivir, my loads were always undetectable. After having my son, I came off my meds and after a 6 month hiatus was started on cocktail theray... I don't remember all three drugs that I was placed on, but I do remember the one that almost killed me --- Viramune. I developed a fullbody rash and sores inside of my mouth - I had to be hospitalized for a week because I would have died from dehydration and starvation. After it cleared up --- I have been hesitant to go back on medication therapy. I am now close to my ten year mark and I have to do everything in my power to make sure that I LIVE for my beautiful son. How likely is it that if I request that my doctor puts me back on Combivir that 1) he will, and 2) will it work for me like it did almost a decade ago?

Thank you.

Response from Dr. Frascino


Your reaction to Viramune, while unfortunate, is a recognized potential side effect of that particular drug. (I had a similar reaction to another drug in that same class!)

If your CD4 counts have now fallen to the point antiretroviral therapy is recommended (CD4 count in the 250-350 range), Combivir alone would not be recommended. Combivir is a combination of two drugs (AZT and 3TC) from the same class (nucleoside reverse transcriptase inhibitors). We now know that Combivir, taken on its own, is not potent enough to control HIV replication long term. There have been remarkable advances made in antiretroviral therapy since your initial treatment a decade ago. There are many more options now, resulting in improved convenience (few pills, fewer food restrictions, fewer doses per day, etc.), increased potency and decreased side effects/toxicities. I strongly advise you discuss your various options with your HIV specialist. He may want to check your resistance profile to see if you have become resistant to any antiretrovirals prior to helping you select your best therapeutic option.

Good luck! I'm here if you need me, OK?

Dr. Bob

Can I cause my partners viral load to spike?
Atripla & Vitamins

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