Dec 12, 2007
Hello. Early this year I started taking ARVs. My first treatment was Combivir + Sustiva, but I developed a horrible rash due to the Sustiva that covered almost my entire body. My doctor then changed me to Combivir + Kaletra. I have tried to manage it for the last six months, but the diarrhea has gotten unbearable, at the point that I have no social life whatsoever. What other treatment options shall I discuss with my doctor in my next visit? Could I take a so-called "Drug Holiday" until Reyataz becomes available where I live (central america), middle of 2008? My CD4 are in the 400's and VL -50. Thanks for the suggestions.
Response from Dr. Henry
Often diarrhea from Kaletra can be helped with a variety of interventions (such as increased fiber, use of diarrhea meds, calcium supplements and others). Drug holidays put patients at risk for both HIV and non-HIV clinical problems and generally result in a reversal of the gains seen on treatment so can not be recommended for most patients. Viramune instead of sustiva might be considered. Other switch options are dependent on drug availability. The diarrhea may lesson with Reyataz so trying to hold out until you can access it may be wise of no other options are available to you. KH
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