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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Mar 14, 2008

I have been HIV pos since about 1980 and started taking meds in the early 1990's. Always have been below detection levels since sensitivity tests first became available. For the last 5 or 6 years I noticed a steady loss in taste and smell. I recently had sinus surgery to correct recurrent infections and removal of polyps. Since just before the surgery and right after I experienced almost no sense of smell and concurrent taste. The doctor put me on a regular regimen of sinus rinses with an added steroid. Still no improvement except for a very clean sinus. The I switched to Atripla after taking an azt based combo cocktail. My smell returned big time, then after two weeks or so it disappeared more or less. My nasal cavities are always dry. Could the anitviral's be the cause of my Anosmia? I am 67. Anonymous in NY

Response from Dr. Henry

Good question. Loss of taste and smell has been rarely reported in the setting of HIV treatment so it is tough to link a cause and effect for a rare/unusual association. I have not observed any patient loss taste or smell due to use of Atripla but have witnessed a low rate of a variety of odd/hard to explain central nervous system side effects. Use of ritonavir can cause tongue/taste abnormalities is a small subset of patients. If any reader wants to share their experience or has a pertinent reference please post. KH

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