Oct 10, 2002
I'm a physiscian and HIV+. I started on meds three months ago with great results virologically and physically. Only problem is a stubborn case of what apears to be erythema nodosum which started 3 weeks after starting on Sustiva/combivir. I have an experienced HIV physician who has never seen this before, but says since sustiva is still a new drug it could be from that and I should consider switching within the class. I don't want to switch given the great response I've gotten; we've both done an extensive literature search without anything turning up suggesting Sustiva's the cause. My agruement is that it's just my T4 cells rev'ing back up and causing trouble. Have you seen/heard of a erythema nodosum rash from Sustiva before?
Response from Dr. Henry
I have heard anecdotally of several cases of e nodosum in the setting of Sustiva Rx. Sulfa drugs (are you on TMP-SMX) are another drug class linked to EN. Immune reconstitution can take some strange paths so that is a good thought. If mild I would try to treat through if you are otherwise pleased with the combination. A switch to nevirapine or abacavir are options if you want to avoid PIs. Please report back! KH
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