Mar 30, 2004
I rashed out pretty badly (whole body from soles of feet to face) with the suspect being the Efavirenz so I have stopped that for the time being.
My Dr. wants to move to Kaletra however I am **very** lery about starting on a PI.
So my questions are:
1) Because I rashed out on one NNRTI does it mean that ll NNRTI's are out of the question?
2) Because I started and then stopped one NNRTI does it mean that my HIV will be resist to all (what's the liklyhood)
3) I am worried about Kaletra with side effect (most of my HIV+ friend have told me to advoid these if I can because of the effects). How founded are these concerns?
4) What other alternative (specifically) could be recommended what would not include Kaletra (PI)?
5) Are am I simply off in left-center field (it's ok to say yes on this one, honest) :-)
My CD4 is just shy of 300 with a load ok 80K.
Thanks in advance, ap
Response from Dr. Henry
I actually prefer starting patients off with Kaletra and then switching to something easier once the viral load is undetectable and everything is otherwise going well. I have used nevirapine after a rash with efavirenz--there is some cross reactivity of an uncertain degree but often that is worth considering. Starting and stopping a NNRTI runs the risk of resistance which often can be missed with standard genotyping so that is an issue in your case. If there is no resistance you could try a nevirapine based regimen but I would try a Kaletra based regimen ( or other ritonavir based PI regimens such as with atazanavir or fosamprenavir) and then decide later whether you want to switch off. KH
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