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How To Best Deal With Warts
Mar 19, 2014

I've been HIV+ for nearly 3 decades. For most of that time I kept my CD4+ T cells well above 1,000 cells/mml with early treatment.

After a year-long drug holiday, I restarted with a generic AZT drug that didn't seem to work. I can no longer take any NRTIs because of broad resistance. And I'm now on boosted Reyataz, efavirenz and raltegravir.

Although I don't have anal warts, I have had dozens of warts on my legs behind my knees frozen-off, as well as warts on my arms, wrists, shoulders, bottom of feet and back of hands. I also have keratinocytes on the side of my chest and skin tags and mollescum on my face.

MY CD4+ T-cells are about 800 with a ratio of 1.1.

My dermatologist says I should have my white blood cells measured - but he wasn't specific.

I visited my dermatologist once a month for the past three months, but the warts just seem to keep popping up. And I can't afford to visit a dermatologist every month.

I see salicylic acid, Zymaderm and Bacroban recommended for warts on children.

I wish that I could purchase a better freeze spray than what's presently available at the local pharmacies for treating warts. I would want something with a pin-point spray. But it isn't for sale to the general public.

Is my treatment regimen suppressing my immune system (as well as HIV)? Should I try swapping one of my drugs for another?

What over-the-counter treatments are safe and effective?

Thank you for your past and future help.

Response from Dr. Henry

Often warts can be difficult to treat even in HIV-negative population but in my experience often worse in HIV+ patients. As you outline well treatment options are frustrating and often effective or with short period of benefit. HIV drugs have not been linked to worsening of warts in the setting of good CD4 counts. Over the counter meds are of modest benefit and also may be ezpensive if a large surface area is involved (ie the freezing sprays that are available in the US dont provide much coverage for each bottle). I wish I had an easy answer for you-if any reader has an experience they would like to share as far as successful management of warts in this setting please post. KH



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