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HIV meds and DVT - relationship?

Sep 13, 2004

I am an HIV-positive 48-year old male. In February 2002, I started on Sustiva, Epivir, and Zerit. These meds worked well: no detectable HIV and 600+ CD4 count. I started exhibiting symptoms of peripheral neuropathy, numbness and pain in my feet in late 2003. By March 2004, it got to the point of interfering with daily life. I suspected Zerit was the cause. On March 18 I stopped all meds. An HIV genotype was ordered: the results were a resistance to Sustiva. On April 30, I was put on Kaletra and Combivir. Two weeks into the regime I had headaches and moderate to severe nausea. During the next two weeks I developed a pain in my lower left leg (Im a runner, so I didnt really think much of the pain), bad headaches, loss of appetite, weight loss (10 pounds) and severe nausea. On June 3, I stopped all meds (with my doctors concurrence). On June 4 (after experiencing slight chest pressure and strange breathing pattern), I went to the emergency room and was diagnosed with a severe pulmonary embolism (left pulmonary artery block 100% and right pulmonary artery blocked 75%). Later that day, an ultrasound was run on my left leg and clots were discovered. I was very lucky to have survived. Im on warfarin to handle the blot clots. Is there any relationship to the HIV meds and the DVT I developed? We havent been able to figure out any other cause. Im currently on the following HIV meds: Reyataz, Norvir, Viread, and Epivir, plus I take Tricor to treat my high triglycerides. Thank you.

Response from Dr. Pierone

There have been reports of higher rates of deep venous thrombosis (DVT) in HIV-infected patients. I am not aware of studies showing more instances of pulmonary embolism, but since DVT leads to pulmonary embolism this would be a logical assumption. Our team has clinical experience that also backs up this association since we have seen more patients with blood clots than one would expect in a practice as young as ours. I have not seen an association with HIV medications, but that does not mean one does not exist.

starting meds or not
High Load; Sustiva OK?

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