Hi doc, have been on meds since 2005 nov started with 3tc,nvp &d4t a yr later developed tingling and painful legs/feet. My doc changed my med to combivir(azt & 3tc) and nvp. recent cd4 440, 21% vl undect. My problem is lactate levels are high(54), bilirubin and some liver fn test, hb is norm. Recently i get this terrible headache affecting the left eye,its like something is eating my brain and also affect sinuses.Should i continue with the sama reg? how to treat the headache and do you think i will stay long on this reg if not what's the best option.

Thanks for your post.

If I can guess the units to your lactate level, a level of 54 isn't usually associated with clinically significant "lactic acidosis"- a syndrome associated with more serious symptoms.

If you have unilateral pain that affects your eye, you should be bringing this to your doctor's attention. The causes of this can be many, but include primary eye problems and sinusitis.

As for switching your medications, the regimen of AZT+3TC + nevirapine is considered an alternative one in current US guidelines; AZT can be associated with headache, though AZT-associated headaches are usually not unilateral. There are other preferred regimens that are thought to be more potent, once-daily and better tolerated-- another topic to discuss with your doctor.

Be well, BY