treatment options regarding h.i.v./h.c.v. psoriatic arthritis ankling spondiolitis
Aug 14, 2014
Doc, I have the abovementioned health issues and have had steroidal injections, ablasions in my lower back bilaterally and most recently sclerosing injections in my sacroiliac joints bilaterally. I am medicated w/ truvada, isentress, meloxicam, oxycontin, soma. I have been hoping w/each treatment for relief. The rheumatologist I see says that there isn't anything he can treat me with due to my other health issues. I had a bad reaction to prednisone and he has deferred me back to my g.p. who has sent me to a pain clinic. They (pain management clinic) put me on the narcotics, soma, meloxicam which I thought would be a short term solution until my ablasions were approved, then done. And when that was a bust the sclerosing injections. Is there in your opinion something we/they have not considered. I don't want to be on the narcotics long term. I still have bad pain on 80mg of oxycontin and am on the max dose of meloxicam. I live in Hawaii and am able to do aqua therapy year round which is great. However I feel everytime I am referred to a specialist they look at the laundry list of medical conditions and medications and punt me off to another practitioner hoping I won't return. Any advice would be greatly appreciated. Thanks, Eric
Response from Dr. Taylor
Dear Eric, Up until recent times, it has been challenging to have an autoimmune-type condition such as psoriatic arthritis and ankylosing spondylitis (AS) in the setting of hep C, because the treatment for each disease could worsen the others. For example prednisone and other steroids for the arthritis could bother the hep C, and inteferon for hep C could exacerbate the arthritis and AS.
However there is very good news for you. There are new pills for hep C that may be given without interferon injections. These are safe for people living with HIV, AS and psoriatic arthritis, as long as your doctors check for any possible drug-drug interactions.
I would talk with your HIV doc about accessing hep C treatment through your HIV doc or via a hep C specialist. You have an excellent chance of being cured of your hep C. Then your 'laundry list' of medical conditions would not include this liver disease. This will permit more choices over time for your arthritis and AS, as some meds for these conditions, such as NSAIDS (a class of anti-inflamatories) over time may not be ideal as the liver gets more scarred. So talk with your doctors about seeing a hep C specialist and getting cured of this infection with pills alone. All best to you.
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