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hemoglobin drop
Apr 20, 2003

I started on a combination of Sustiva, Epivir and Viread about 3 weeks ago. I was treatment naive before that. CD4 151, VL 600k. I had my Hemoglobin checked on Feb 27,2003 and it came back 12.9. Here is the history of my hemoglobin: 12-03-2002 14.3 1-07-03 13.5 1-09-03 14.4 (i redid a test) 1-27-03 13.8 3-24-03 13.2 Feb 27,2003 Started HIV drugs. April 10, 2003 12.9

I asked my doctor if I should be concerned about the drop in my hemoglobin... and he talked about a 1 point drop as significant... however he didn't have any red flags go up.... so I decided to just try adding iron recently. Should I have any concerns about this drop at this point? Will the hemoglobin normally recover in time? Any way to keep the hemoglobin up? Thanks.

Response from Dr. Boyle

No, I wouldn't be terribly concerned since the drop is relatively small, none of the medications you are on has a signficant bone marrow toxicity associated with them, and hemoglobin can vary a bit (sometimes its just due to laboratory error). However, you should have your hemoglobin quickly re-evaluated to make sure that it has not dropped any further, and, if it has declined signficantly, you should be evaluated to make sure that you are not having some other cause of blood loss and the discontinuation of your antiretrovirals should be considered while that evauation is underway.

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