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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Love Atripla - Hate the Rash
Mar 28, 2012

I have been on Atripla for four months now. Started with CD4 107-7% / VL 258K. Now I am at CD4 318-15% / VL 38. My doctor says these are great results, and I like the convenience of one pill and the minimal side effects to my GI. Even the reported "vivid dreams" have been almost non-existant. The one thing that is driving me crazy is this rash that I developed a couple weeks after starting the Atripla and has not yet cleared up.

It starts as a very itchy red bump, like a pimple almost. The itching will stop after a day or two, but the red spots remain for weeks. It is all over my chest and then a few spots here and there on my arms, back, neck and side of my face. The rash generally clears everywhere except for my chest. I thought my chest was clearing up about a week ago. It improved but seems to have stabilized and is not getting any better now.

Just wondering if you think this is something that will get better in time or if after this amount of time, it will probably stay the same?

I don't want to change meds if I don't have to. I had some bad side effects to bactrim early on so I'm really afraid of the GI side effects of other meds. My doc and I picked the Atripla for its "crazy" side effects rather then the GI side effects of other meds. But I don't know how much longer I can deal with this rash.

Thanks for your time and look forward to your insight.

Response from Dr. Henry

Unclear whether the rash is a drug hypersensitity or a flare up of some other condition such as eosinophilic folliculitis that can worsen as a spectrum of immune reconstitution. Recommend discussing with your HIV specialist re more diagnostic evaluation (ie skin biopsy or consultation by a dermatologist) my be worthwhile to better define the diagnosis and then targeted treatment information. KH

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