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Ask the Experts about Opportunistic Infections

 

thrush and hairy leukoplakia (second question)
Sep 27, 2001

Thanks for answering my question (thrush and hairy leukoplakia, Sept 18). I've been using the Sporanox twice daily, and the thrush is gone. I also started the 800 mg acyclovir 5 X daily, and the HL is shrinking. My question is, if I stop the Sporanox, and only use it when I need it, can I be developing resistance to it? Or can using it all the time actually help develop resistance? Also, if I stop the high dose acyclovir, is there a problem with not using it unless the HL returns? I just don't want to be on too many drugs needlessly. Thanks so much for your answers

Response from Dr. Feinberg

It is best to treat these conditions episodically, each time they arise, than to stay on the medicine continuously. Especially for azole antifungal drugs, resistance occurs as a consquence of the total duration of exposure. If you are taking an effective combination of meds for your HIV, your immune system should get enough of a boost so that you're not plagued with recurrent mouth infections.



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