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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Side Effects- New Meds
Mar 19, 2007

I am in the acute infection stage, and recently started medication (Reyataz and Epzicom). After 24 hours of the first dose, I noticed a few red circular bumps on my upper back and shoulder. Then I took the second daily dose and now 48 hours after starting the medications, the rash has spread all over my body (not face or on hands) and it is beginning to itch. I called the doctor and stopped taking the meds because Epzicom has serious warnings about allergic reaction. What do you think the chances of switching to Atripla will be for not experiencing a painful, and "ugly" rash? And how long does the rash usually last and are there any medications that will clear it up quickly? Thank you for your time.

Response from Dr. Henry

I often would not use Reyataz + Epzicom for patients with primary infection --would prefer to use a boosted PI. When I use Epzicom I check a HLA B5701 haplotype before hand-if it is negative the chances to have an abacavir hypersensitivity reaction are very low. It is somewhat unusual to have a rash to due abacavir within days of starting treatment (if an abacavir reaction usually other symptoms besides rash). I am cautious about using Atripla up front unless I am sure there is no NNRTI resistance (need to get a genotype before starting therapy). HIV specialists are used to dealing with these issues. Drug rashes usually clear within several days but immune reconstitution reactions and other conditions can make the diagnosis murky so being seen by your experienced HIV provider is wise. KH

Atripla and smoking marijuana
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