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PEP for 2 weeks with Slight Lab Abnormalities--Stop or Decrease Dose?
Oct 5, 2007

Hi I had receptive unprotected anal sex with someone of unknown status. My doctor started me on PEP program 24hrs later with Epivir, Retrovir, and Kaletra. I had lots of fatigue and side effects so Kaletra was decreased to one tab twice a day from the two tabs about 5 days into course. I had baseline labs which were all normal, including HIV. 2 weeks into PEP, i had labs which are borderline abn: bun 21 (nl <19)/creatnine 1.2 (nl < 1.3), ast 52 (nl <40), alt 67 (nl <35), and wbc 3.5 (nl >4), otherwise everything else was normal. The fatigue is manageable but my doctor is recommending decreasing the dosages further of the epivir and retrovir but I am worried about the efficacy of PEP at this point....are these lab values really so abnormal that i should decrease PEP or should i just continue on for two more weeks without worry? please help

Response from Dr. Henry

Those labs alone would not sway me to make a recommendation to stop PEP. That decision would be based on the details of the exposure and the magnitude of your side effect symptoms. The effectiveness of 2 weeks of PEP has not been well studied/demonstrated so cannot be generally recommended if prevention of infection is the main goal. KH

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