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Say it ain't so!

Jan 7, 2014

Hi Dr. Young,

I've had hiv for a year now and my current cd4 is 827 and vl is 179. Doctor doesn't recommend starting hiv meds given my cd4 count, and suggested that I start them when my cd4 drops below 350, which hopefully won't be for a while.

Ok, but I read somewhere the grapefruit juice can interact with hiv meds?! Say it ain't so! I have enjoyed my grapefruit juice throughout the years (about three glasses a week) and would really not like to give it up if I have to start meds. Why is it that it's only grapefruit that interacts with hiv meds but not other citrus fruit juices?


Response from Dr. Young

Hello and thanks for posting.

Current HIV treatment guidelines recommend starting treatment irrespective of CD4 count (US) and when counts are below 500 (rest of world, except the UK).

The issue with grapefruit juice (but not other citrus juices) is the potential to interfere with drugs metabolized by the liver cytochrome P450 system. As such certain HIV medications, especially the protease inhibitors) could be affected.

Further, it takes frequent consumption of grapefruit to be relevant- but the impact depends on the medication that you might be taking. A glass every now and then is usually not significant.

Hope that helps. BY

Complera (eviplera) and hydration.

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