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First change in meds
Oct 15, 2001

Dear docs,

I begun HAART last May. My v/l was 100k and CD4 380. I begun takink AZT/3tc and Efavirenz. About 1 month ago I developed neuropathy, anemia and white cells dorped to 900. My doc decided to suspend AZT and change it to d4t. Was that a smart move? Im scared to death! A first change in tratment only 3 months after the begining? What are my prognosis? Thanks. Robert

Response from Dr. Pavia


There is a big difference between swapping out one medication of a regimen that is otherwise working (which is what you are doing) and changing because a regimen has failed. You really are not using up any options. Assuming the switch to D4T does the trick on correcting your anemia and low white count, you should be in very good shape. There is no need to be scared to death.

I think the switch makes great sense as a first move, since AZT can cause (in some people) big drops in the red and white blood cell counts. It is a little concerning that you also have neuropathy, which is less commonly blamed on AZT. D4T can also cause neuropathy, but it is not very common for D4T to cause it in someone with 300 CD4 cells.

I wonder if you have had a vitamin B12 level and a folate level checked, since these can be low in people with HIV and can cause anemia and neuropathy. If the switch doesn't do the trick, those might be a good idea to check.


Milk Thistle
Doctor Murphy ?

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