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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Severe Allergic Reactions
Jun 25, 2010

I am 45 and have been positive since 1990. I have started treatment 3 times, twice in 1998 and again last December. After 4 weeks on Viramune, Epivir and Zerit I developed a severe rash which covered my entire body below the neck with blisters between my fingers and toes. One month later a single dose of Sustiva, Epivir and Zerit resulted in the same reaction which lead my physician to believe I was allergic to the entire class of NNRTI. Six months ago I had the same reaction after 4 days on Isentress and Truvada and I now question if the common thread might be Epivir and Emtriva. These miserable experiences were all successfully treated with prednisone and my only known allergy is to penicillin.

I am very concerned about starting another course of treatment. My t-cells, while averaging 500 for nearly two decades, now stand at 321 and my viral load remains in the 2-3,000 range.

How can I know for sure what I am reacting to? Is allergy testing an option? Even if my strain of HIV is genetically tested prior to starting treatment again can I be sure I wont be allergic to it? What combinations should I consider?

Response from Dr. Henry

It might be worth working with an allergest to do some form of home grown patch testing. Checking HLA B5701 status and considering a novel regimen such as a boosted PI + maraviroc (if CCR5 virus) or raltegravir +/- tenofovir would be considerations in order to avoid the 3TC/FTC meds that were common link in earlier efforts. KH

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