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sustiva, truvada

Apr 8, 2007

hi doc, thanks for an excellent site and forum. i was diagnosed concurrently 2 months back with HIV and invasive sqamous cell anal carcinoma. my clinician started me on sustiva and combivir and my CD 4 increased from 167 at start to current 407 and VL undetectable. generally i had minmal side-effects and was feeling physically and mentally quite good. due to the need for further chemo/radiation treatment and evidence of some bone-marrow suppression (poss. by azt) my specialist switched me a week ago to sustiva and truvada. i am suddenly feeling miserable! sleeping less well than previously, loss of appetite, intermittant nausea, genaral wekaness. i am also currently on 1600mg twice daily of bactrim (for about 10 days) and 400 mg once daily (for 5 days) due to a recent outbreak of boils and drainage of an ischiorectal abcess which appears to have been caused by MRSA. any thoughts comments on whether these are side effects from the change to truvada or perhaps interactions with the current high dose antibiotic regime? i realise that patience is probably needed but just wondered why i am suddenly feeling phsically and emotionally so much worse since the changeover. your thoughts/suggestions?many thanks, d

Response from Dr. Young

D, thank you for your post.

The switch from Combivir (AZT/3TC) to Truvada (tenofovir/FTC) is only rarely associated with new side effects.

It would be my guess that either your Staphy abscess or the use of Bactrim DS could cause the nausea and anorexia. Nausea, vomiting and anorexia are at the top of the list of common reactions to Bactrim.

No matter what, I'd let your doctors know about the severity of your symptoms. This would be important from a simple medical monitoring standpoint. It may be that there are reasonable alternatives to the medications that you're currently taking.

Best of health to you. BY

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