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HIV+ HBV+, tenofovir+interferon?
Jun 17, 2007

Male, 43 years old, 100 Kg, 1.7 m, hiv+ since 1986, HIV viral load<50, CD4 300. Hepatitis B+ with HBV viral load 490'000,000. Lypodistrophy, bull hump, diabetes (124), triglycerides (250), hepatic enzymes lightly high, My last HAART was Lamivudine, Kaletra, Stavudine (after changed for Abacavir) by 6 years. My doctor want to change due to side effects and treat me now with Tenofovir, Emtricitabina, Ritonavir, Atazanavir for HIV; lamivudine (Ive been taking it for 7 years) and Pegasys (Interferon 2a)(48 weeks, 1 dose per week); besides that, bezafibrate, glibenclamide, pentoxyfilline, allupurinol. Also dorzolamide and latanaprost for glaucoma. Is this treatment ok? Please some suggestions about taking pills schedule? I feel exhaust (fatigue), articulations pain, Ive not been able to lose weight, I have apnea too (using CPAP), short term memory lost. Thanks a lot doctor.

Response from Dr. McGovern

Several comments: 1. I agree with your physician that pegylated interferon is worth a try, although there is no published data in coinfection. It appears that you will also be getting combination therapy for hepatitis B - tenofovir is a very active drug. 2. The emtricitabine will probably not add anything for hepatitis B control because you have probably become resistant to its cousin - lamivudine. However, your physician may be prescribing that to treat your HIV. 3. I think the switch to an atazanavir combination is a good idea to lessen your risk of other metabolic problems that may contribute to NASH (non-alcoholic liver disease) such as high triglycerides.



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