Jan 2, 2006
I am currently on a regimen of Truvada, Reyataz and Norvir in addition to Bactrim 3xweek and Zithromycin 2xweek. I could not tolerate Sustiva at all and I felt the Sustiva was causing the rash problem actually. I have been off of the Sustiva for about 2 weeks and am still having problems with a rash..not as bad but still irritating and itchy. I understand Bactrim can cause a rash also but have also read about something called immune reconstitution syndrome that can cause all sorts of skin problems too. Instead of Bactrim could I switch to Dapsone as a prophylactic against PCP? My T-cells are still quite low so I understand the need for Bactrim but the rash is really quite irritating. What can you suggest might be causing this rash. I started HIV meds for the first time ever on 10/12/05 and switched to Reyataz/Norvir on 11/23/05. Thank you for your time.
Chuck Palm Springs
Response from Dr. Pierone
Skin problems and rashes are very common with HIV infection, especially during the early course after initiation of HAART. Bactrim is one of the most likely culprits for a new rash, although a residual effect from the Sustiva is certainly possible. If the rash does not improve your clinician may suggest changing from Bactrim to dapsone for prevention of pneumonia. Best of luck to you!
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