Thanks dr young for your efforts and help. I am on Genvoya and i have to undergo a colonoscopy soon. I have read that you are normally sedated with midazolam. Is it advisable .? Should i tell the doctors that i am Positive? Is it really necessary?
Hello and thanks for posting.
Congratulations on getting your (I'll assume) screening colonoscopy. It's recommended for all people over the age of 50 to look for colon cancer or precancerous lesions. There's concerning data that suggests that people living with HIV are at greater risk of colon cancer than uninfected people of the same age.
You're on a highly recommended initial HIV treatment (Genvoya)- one of it's main liabilities is that the cobicistat component has many drug-drug interactions- interactions that could increase the drug levels of other medications. Unfortunately, midazolam and Genvoya have a contraindicated drug-drug interaction that would significantly increase the risk of midazolam toxicity, including risk of depression of respiratory rate and prolonged sedation.
Yes, it is entirely necessary to tell your doctors that you're positive. In my opinion, it's always a good thing to tell all of your care providers about the medications that you take, and yes, that means telling them about your medical conditions, including HIV. The reasons for this include accounting for possible serious drug interactions, but the diagnostic information that you provide might also assist in the medical assessment that these non-HIV care providers are working on. Any doctor that's off put by your HIV diagnosis probably shouldn't (and doesn't deserve to) be your doctor.
I hope that this is helpful,