Nov 8, 2010
A year prior to going onto medication I started getting red welts on my face CD4 count then was approx 300-400. Symptoms became more problematic as my CD4 count deteriorated to 200 over the following 12 months. Starting Ritonavir 100mg, Atazanavir 300mg, Emtriva 200mg and Tenofovir Disopr 11 months ago, my CD4 count is now back over 300. However, on starting meds, the skin issue escalated to include the entire body. I did determine over time that it was caused by exposure to daylight. A skin disease specialist diagnosed it as extreme Polymorphic Light Eruption without actually conducting any tests. Numerous treatment options had no positive effect. These include 4 months on low dosage of antibiotics and Anti Malaria pills. I had hoped that as my health resumed on Meds, the skin issue may get better as well. Unfortunately this is not the case. Niether the HIV nor skin specialists can find any research supporting correlation between HIV/Meds and extreme photosensitivity. I have also been on Paroxitine for 12 years. I am trying to wean myself off this in the hope that may help. Can anybody assist as I have become a prisoner in my own home?
Response from Dr. Henry
I have seen a small number of patients who seemed to develop UV light sensitivity from HIV infection-their course was variable and not consistently improved after starting effective therapy. It might be worth considering switching your HIV meds around to see if they are in some unusual/rare way contributing. Otpions depends on your treatment and resistance situation. I might first consider switching the ritonavir/atazanavir to perhaps raltegravir and see what happens to the skin situation. Alternative to the Truvada also are available (Epzicome if HLA B5701 negative or Combivir). Paroxitine rarely causes severe skin problems but is still a consideration if further efforts draw a blank. Would also reduce use of any alternative medications you might be taking until this gets sorted out. Good luck. KH
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