Dec 4, 2003
I was diagnosed with hiv 6 yrs ago. I started on combivir which didn't work fast enough for my doctor so he switched me after 6 mos to Norvir, Fortavase, Zerit, and Videx. My current viral count is undetectible, and my cd-4 count is over 1100. A week ago he switched me to combivir and sustiva due to the ugly fat changes in my body. But after a week I developed a rash all over my chest, stomach, and arms. I contacted my doctor and he told me to stop taking all meds until I can see him 4 days from now. Is that safe? Could the Sustiva be causing the problem? Is there another drug combo I could try that won't have the fatty tissue problem the protease inhibitors did?
| Response from Dr. Henry
Rashes with Sustiva are fairly common and can often be treated through (Benadryl, Tylenol might help). Stopping Sustiva and/or 3TC can result in resistance if not done carefully (sequenced stopping or use of another drug of a week). Nevirapine is also used in that setting but with a rash that would not be a good idea (to substitute for Sustiva). Use of one of the newer PIs with perhaps less lipid/fat problems is another option (such as atazanavir or phosamprenavir). If you never have been sick with AIDS and never had a CD4 count < 350 then another issue is whether you should stop your treatment for a while since. I would discuss further with your HIV provider.
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