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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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May 26, 2003

I am a 56 year old male who was diagnosed with AIDS 3 years ago. My t's have risen from 44 to 171 and my viral load has been negligable since I started treatment. I am on Sustiva and Combivir. My major problem is neuropathy in my feet and the sometimes horrific pain that comes with it. I was first given neurontin but there seemed to be no positive results so I was switched to Nortriptyline and am now on Amitriptyline. I know that these drugs are also used as anti-depressents but my depression has become so bad that I often feel that I am at the end of my rope. I am not sure where to turn next but the pain in my feet is becoming unbearable and my depression deepens. Any suggestions? (Thanks for the service you render and for all that you do)

Response from Dr. Henry

Seeing a good neurologist can often be helpful. The 3TC component of Combivir can sometimes aggravate/cause peripheral neuropathy so a switch to something like abacavir or tenofovor in a trial basis may be worth trying depending on the details of your situations. Some vitamin deficiencies can aggavate/cause peripheral neuropathy. Some alternative treatments can help (such as calcium, magnesium pills, L-carnitine, etc) in a variable manner (see or Jon Kaiser's bood Healing HIV). For ongoing severe neurpathy, high doses of Neurontin and lidocaine patches have been most helpful in my experience. KH

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