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Steven's Johnson !!! please adv !!
Feb 9, 2005

Hi there, I am 30 female, been tasted as hiv+ about 10 years ago,i have a quite long history, but to be short .... i have suffered from hard lypo for many years, about a year a go my dr. decided to take the zerit off the combination and so i am takinng viread,stokrin and videx.my vl is below 25 copies and cd4 higher then 700. i got married 6 month ago and we've started on havig a baby, my dr said i should take the stokrin off and gave me the viramune, and here the problem started, i have developed imm alergic symptoms and been taken imm to Emergency dept. at the hospital , i was 7 days at the ER and now i am gettig better at the hospital, my dr says my body got into a real shock and all systems stop working including the kidney and liver , i was pretty close to be gone ... This was a STEVEN JONSON disease , never herd about it before, Can u please tell me what do u know about this disease and how it relates to HIV? Now since obviously the viramune is not good for me, i'll get back to the previous combination with the viread+stokrin+videx , and later on when i'll thik on getting pregnant my dr says he'll give me the Kaletra instead of the stokrin along with the viread and videx, i would like to have your opinion regarding this combination and regarding all the above .. I should mention i have already took Kaletra in the past and except the Lypo i didn't sufered from any strange side effects ,,will the kaletra be good enough while beeing pregnant? i will get back imm to the stokring after 9 month of pregnancy .. Love to hear your opinion.

Response from Dr. Henry

Stevens-Johnson is a severe (life threatening) form of erythema multiforma often characterized by lesions on the skin, lips, mouth, eyes with fever and severe discomfort. It can occur as an reaction to drugs including nevirapine (< 1% of patients on it). I have had numerous pregnant patients take Kaletra during pregnancy without any obvious problems. There is a concern particularly from Europe that use of PIs during pregnancy may modestly increase the risk for prematurity. The ACTG in the US has a study of use of both PIs and NNRTIs during pregnancy looking at metabolic issues (results should be available soon). I am comfortable using Kaletra in pregnancy with close monitoring (there is also a concern about the levels of lopinavir being lower in pregnancy that needs to be factored in to a decision about which drugs and dosing). KH



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