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new to treatment-horrible rash

Mar 29, 2005

I was diagnosed with HIV 6 weeks ago. My t-cell count is 76, viral load 109,000. I was taking Sustiva, Combivir, and Bactrim for PCP pnen. ^ days into therapy, I got a terrible rash that was very itchy. My doc gave me a prednisone shot-rash went down a little(He thought it was the Bactrim)-Started Combivir only 3 days later--2 days on Combivir, rash came back as strong as ever. This rash moves all over my body, and is symmetrical.I.E-It will come out on my right forearm, stay for 45 minutes, then reappear on my left forearm. I have been on prednisone for 2 weeks(10mg) per day. The rash is subsiding very slowly, but is it possible that this is not an allergic reaction. Thank you for any assistance you may have.

Response from Dr. Pierone

This is not an uncommon complication of early therapy. Bactrim is a sulfa-based antibiotic that we use to treat pneumocystis jiroveci pneumonia and the main potential reaction is rash. Sustiva may also produce a rash during the initiation phase of therapy. Combivir rarely leads to rash and is much lower on the list of suspects.

Sometimes we can treat through the rash with short-term corticosteroid coverage and maintain therapy. Other times the regimen needs to be changed to deal with the reaction, it just depends on severity of the rash and the overall trend. Hope that this helps and good luck to you.

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