Mar 9, 2004
i began treatment for my hiv about 3 weeks ago. i started on sustive and combivir. after 10 days i developed a severe rash, fever and nausea. my doctor said it was an allergic reaction to the sustiva. he said it was stage 3 rash. he has been weighing options for my next drug regiment. he is leaning toward a viramune/combivir combination but is fearful of what kind of reaction i could have. i went to another doctor for a second opinion and he said i should go to a pi/combivir combination. i am hesitant to do that. i am worried about what effects viramune could have on me. any suggestions or research data to assist me in my decision?
Response from Dr. Henry
Many patients can do OK after a rash from Sustiva using Viramune or visa versa. I personally prefer to use a boosted PI in that setting and then once the HIV level is undetectable look at options for simplifying treatment. There is no right answer but I get nervous about starting and stopping drugs like Sustiva or Viramune too often when first starting treatment due to concerns about resistance and not being to tell when one rash is stopping and another is starting. KH
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