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Alternative Protease inhibitior
Nov 15, 2010

Dear Dr Franscino, My wife was occupationally exposed (blooded blade) at work with a known HIV+ patient (CD4 120, viral load unknown). She was given Combivir within the hour but at my insistence (both surgeons) I added Aluvia (developing-world equivalent for Kaletra). Her vomiting stopped with 5HT blockers (ondansatron) but generally she is feeling awful (lethargy, nausea etc). Can you tell me if it is safe to try an alternative PI during the 28 day PEP period? Are some PIs better tolerated than others? I do not have access to an HIV specialist for advice, but can prescribe certain drugs if they are available here. Thanks, DG (South Africa)

Response from Dr. Frascino

Hello DG,

Yes, it's perfectly reasonable to switch to an alternative protease inhibitor if your wife is not tolerating Kaletra. Ritonavir-boosted atazanavir or darunavir would be options.

Good luck.

Dr. Bob



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