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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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If you can't take the Rash
Nov 2, 2005

Dear Doctors, Dr. Henry writes frequently that one should try to work through rashes. I am one of those people who has tried Bactrim and two anti-HIV regimens, each time to have a horrific rash. The first regimen was reyataz & truvada based and gave me yellow eyes and then bad rash. We waited and switched to Sustiva, Truvada and AZT, 10 days later, rash again. One question- my doctor gave me prednisone from the start of this last regimen- you say that steroid is not effective? And this last rash was so bad that there is no way I could have worked through it- it covered my body, made my throut and tongue swell, five days after stopping treatment I'm still miserable. We are looking at perhaps an Invirase, AZT and Norvir next but I feel sure due for my rash. What do you suggest - is there any way to build up to certain regimens or soemthing different to try? I have been positive 15 years and went from a slow progessor to out of treatment options in just a few months.

Response from Dr. Henry

Rash due to AZT is rare but possible. A double boosted PI regimen without any nukes is an option (such as Kaletra + Reyataz or Invirase or Invirase + Reyataz + low dose ritonavir). Rash due to 3TC or FTC or tenofovir can occur and it is a tough call in the setting of starting multiple medications. Your HIV specialist is the best person to evaluate whether one of the nukes can be reasonably used in a new regimen. KH

switching time of Sustiva
more lipodystrophy

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