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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Nerves discomfort at feet
Sep 11, 2013

Hi doc! I was diagnosed in 2007. Started on single pill SLN3(Stavudine,Lamivudine,Nevirapine). Soon switched to 2 pills Combivir & Nevirapine in 2008 to avoid Stavudine when complained to doctor about nerves discomfort. Currently, VL is undetectable, CD4 is around 300, nerves endings at feet still uncomfortable! Is it neuropathy? Is it side effects of the ARVs or other causes? Tried Neurobion & Gabapentin but no lasting effect. Should I switch regimen or ask for other nerves pain killers? Thanks a lot! Malaysian Poz.

Response from Dr. Henry

Zidovudine and to a lesser extent lamivudine can sometimes contribute to persistent peripheral neuropathy. Switch to tenofovir or abacavir from xidovudine might help some. Often better to switch before problem gets worse. Amitriptyline may be of some help in some cases. Patients with low CD4 counts can develop HIV related neuropathy that may only partially improve on effective treatment. A medical assessment for presence of any other contributing factors (ie diabetes, vitamin deficiencies, other drugs) is also recommended if not done already. Unfortunately, treatment for established peripheral neuropathy remains frustrating. Though peripheral neuropathy is still occurring it has fallen off the drug company and government research priority agenda due to false impression that it is less and less of a problem (absolutely a problem in areas using the older HIV drugs and still seen but at lower rates in areas with access to newer drugs). KH

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