hello doctor ...thanks again for answering my previous questions. iam 40 Indian cd4 348...i have been to art treatment for last 45 days. everyday iam suffering after taking treatment. initially i had skin rashes all over body and ear infection. i was taking zedovine,lamiudine&nevrapine morning and night. after rashes doctor changed nevrapine to effiraveng. so iam taking zedovidine+lamiudine morning and night. and effiranvenz in the night fro last 15 days. every night bad dreams. skin rashes gone completly,but i can see wrinkles dry skin on both the arms. before i was very active man now always in hangover till 5pm. people says it will go after 1 month or so. u suggested me to change to nevirapine instead of effiravenj. iam afraid if again rashes appears?now a days iam taking hygienic food. vitamins etc. iam annoyed. kindly advice doctor.

If hangover persists then may consider changing timing of efavirenz in the AM or a lower dose if have suppressed OK and other dose formulations are available. In US we would consider a boosted protease inhibitor based regimen if continuing to have problems with NNRTI class of drugs. KH