Apr 7, 2004
Hi Drs, I am from asian country, i was infected since 1999 and started medication of 2combivir+4stocrin last year march at cd4 count of 7. I have been taken this combivir & stocrin for about a year now and my cd4 increased to 100 last week and vl of below 50. My weight increased from 38kg to 60kg. I am very happy with my improvement of taking this medication. My questions are 1) can my cd4 count increase to 500. 2) i currently having some side effect ie; insomnia, rash & few red dotted spot, vomiting, fatigue, cough, mussle cramp. Should i change the combination of med. my dr. advise me to take 3 stocrin on next week. Will my cd4 count drop if i take 3 stocrin. i need a second opinion. TQ
| Response from Dr. Young
Thanks for your post.
Sounds like you're probably in Europe, where efavirenz is marketed under the name "Stocrin".
Assuming that your Stocrin pills are 200 mg, the conventional dose that we use here on the other side of the pond is three 200 mg capsules, daily. So, changing from the unconventional dose of 400 mg daily to 600 mg daily should not cause any problems, and might improve your side effects.
Now, you did indeed start therapy with a very low CD4 count. A glimpse at recent efavirenz-based clinical trials shows that CD4 counts continue to rise years after starting therapy-- on average well over 100 cells per year. It is entirely possible, assuming drug sensitivity, excellent adherence and limited or no toxicity, that you'll get to a CD4 count of 500. It will take time and patience.
The side effects that you're experiencing sound troublesome, though it's tough to be certain from what you've described, as to what's causing the problem. The insomina is almost certainly due to efavirenz and should improve with time; the rash is more bothersome to me as a doctor and could be a mild (or not so mild) drug allergic reaction. Because of this later point, I'd be sure to let your doctor know about this and the other side effects that you're experiencing.
Good luck, stay in touch and thanks for reading. BY
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