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My daughter is HIV positive and refusing her meds.
Sep 29, 2007

Hi. Thanks for taking the time to answer my question. My daughter, 2 years old, is HIV positive. She almost died of pneumonia at 5 months old before she was diagnosed. It is a long story how she got infected but she is on

Zidovudine/Epivir/Kaletra combination. Her viral load fluctuates from 100000 to 5000 but has never been undetectable although her CD4 count is quite stable and high. Lately, she has been refusing the meds because of the Kaletra oral medication. The bitterness of this med. is really traumatizing her and I really empathize and sometimes cry that she has to be going through this. There is really no point stuffing her with this when she really ends up not taking everything and has to go through this agony. My question is that is there any other med. that can be taken in place of oral Kaletra? Personally, I feel that she is better off taking just the first two because the Kaletra makes her puke everything. I need to discuss this with her doctor but I wanted to get some advice and options before talking to the doctor. Thanks

Response from Dr. Wohl

I think this is a very serious problem. I am sure you have spoken with your daugther's HIV doctor. What does she/he recommend? The options available to you depend on which country you live in as not all HIV meds, especially those in liquid formulations, are available everywhere.

If you are in the US, you need to consider a switch either to a new regimen or new formulations. Kaletra does come in a tablet now and while the manufacturer would never recommend it, some pediatricians do use this and break it in halfs to get at the appropriate pediatric dose. Still, your daughter may be too young even for this.

There are a few other medications that she might be able to take but, importantly, before jumping from this regimen, a resistance test should be performed to see if the virus is resistant to the medications she is currently prescribed. Such testing will help the doctor chose the medications that not only may be better tolerated but also will be more likely to be effective. Taking only zidovudine and Epivir may not be a good idea and can lead to resistance to these drugs.

This is a very common problem among children with HIV infection. You do not have to deal with this alone. Your clinic should be able to support you and help you brainstorm to find a way that works best for you and your family.

DW



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