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What should I continue?
Jan 30, 2010

I had a one night stand Sunday night. I was told the next day the woman was HIV+. Needless to say, it's been a long week.

I went to the ER and was put on Truvada and Kaletra within 14 hours. I'm taking two Kaletra twice a day, and then one Truvada also. I've felt fine, but have had this rash on my upper back that now seems to be spreading. My doc told me through his nurse to discontinue Truvada, and just stay on Kaletra taking the two pills, twice a day. He said this should probably do the trick, and it's most likely the Truvada causing my outbreak. Does this sound like sound advice? Have you heard of this before?

The rash is annoying, but if it comes down to becoming HIV+, and having a rash for a few weeks, I would rather stay on the two drugs.

Response from Dr. Young


I believe that I'm familiar with your case. The regimen of Truvada with Kaletra is a standard PEP.

The issue in your case though is that absent any other new medications, it seems like your developing an allergic reaction to one of the PEP medicines. While it's difficult to be sure (and rashes to either are not common), it's possibly more likely to develop to Truvada rather than Kaletra.

The only way to know which medication might be causing the problem is to stop; this is problematic during PEP, since we'd like you to stay on medication if possible. Fortunately, there's considerable evidence that Kaletra alone (or monotherapy) is quite effective for persons with established HIV infection. Therefore, a modified PEP regimen (for your specific case) of Kaletra isn't too unreasonable-- at least until we sort out this rash.

Fortunately, because of your type of exposure (insertive vaginal intercourse) your overall risk of acquiring HIV is very low. PEP (even if only Kaletra) should further reduce this risk.

I hope this helps.


Truvada & Epzicom regimen?
Time to switch?

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