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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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viramune "sunburn"
Feb 6, 2004

Hello. I've been HIV+ for almost a year now. Started with an extremely high VL load (approx. 2 million) lowest CD4-200. Now I am undetectable and CD4 is 400. I began with Kaletra & Combivir but had severe GI problems. Cut Combivir switched to d4t & 3tc - was better but still had probems... We've stopped Kaletra and started on Viramune in September. Since then I have had a perpetual "sunburn". Not severe or itchy, but always there. Especially pronounced at base of neck (sort of like a trucker's tan). My question (and sorry it took so long to get to) is... are there long term health issues with this kind of reaction? I've read that Viramune and rashes are common but go away after a couple of weeks.

Secondly, I'm concerned with d4t and lipostrophy issues...the regime I'm on seems to be working, could I switch to something with a less notorious repution? Thank you.

Response from Dr. Henry

I have observed some hard to explain localized rashes that we ultimately attributed to one of the HIV drugs leading to a switch in some cases. Switching the D4T to tenofovir or abacavir is a common manuever to minimize risk for lipoatrophy. Switching the Viramune to Sustiva (efavirenz) or a PI such as Reyataz is also fairly common these days of one is possibly having a problemwith Viramune. KH

Sustiva versus Viramume, which is the bigger Lipodystrophy contributor?
Reyataz effects

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