Help, I am taking one drug instead of three
SOMETIMES ARVs have to be stopped if they are found to be hurting the patient more than they are helping. Close monitoring by a qualified healthcare provider is very important when one is on antiretroviral therapy (ART). The most likely offending drug here is Zidovudine, which is combined with Lamiv
Dear doctor, I was put on antiretroviral therapy (ART) about six months ago and was doing well, but the drugs had to be stopped because I developed body pains and felt weak. The drugs, Combivir and Efavirenz were stopped and I was given Alluvia. Isn’t being on a single drug (Alluvia) instead of the three I was taking dangerous? I hear I can develop resistance.
James
Dear James,
SOMETIMES ARVs have to be stopped if they are found to be hurting the patient more than they are helping. Close monitoring by a qualified healthcare provider is very important when one is on antiretroviral therapy (ART). The most likely offending drug here is Zidovudine, which is combined with Lamivudine to make Combivir.
This drug at times leads to accumulation of lactic acid in the body, which can lead to body pains and weakness like you had. This condition is known as lactic acidosis and can be very nasty.
Normally when this happens, the offending drug has to be stopped and substituted with another.
But in this case, it was difficult to find a safe substitute for Zidovudine so all the drugs had to be stopped. However, if all the drugs were to be stopped abruptly, it would leave you with high levels of Efavirenz in your blood because this, unlike other drugs, is long acting.
In your case that single drug acting in the body would lead to drug resistance. The use of Alluvia is to provide your body with other drugs so that Efavirenz does not continue acting in your body alone.
Therefore, Alluvia, which is a second line drug (with two drugs in one) was given to you for a week as “a lead out dose†to tail off Efavirenz, after which you will be put on a safer regimen.
Putting you on the next regimen will be done after monitoring that the levels of lactic acid in your body have normalised.
A safer regimen of ARVs such as Tenofovir, Emtricitabine or FTC and Efavirenz can now be got in a fixed dose combination as one tablet called Atripla, which is taken once a day at night.
Send your question on HIV to Health Editor, The New Vision.
P. O. Box 9815, Kampala
or health&beauty@
newvision.co.ug
James
Dear James,
SOMETIMES ARVs have to be stopped if they are found to be hurting the patient more than they are helping. Close monitoring by a qualified healthcare provider is very important when one is on antiretroviral therapy (ART). The most likely offending drug here is Zidovudine, which is combined with Lamivudine to make Combivir.
This drug at times leads to accumulation of lactic acid in the body, which can lead to body pains and weakness like you had. This condition is known as lactic acidosis and can be very nasty.
Normally when this happens, the offending drug has to be stopped and substituted with another.
But in this case, it was difficult to find a safe substitute for Zidovudine so all the drugs had to be stopped. However, if all the drugs were to be stopped abruptly, it would leave you with high levels of Efavirenz in your blood because this, unlike other drugs, is long acting.
In your case that single drug acting in the body would lead to drug resistance. The use of Alluvia is to provide your body with other drugs so that Efavirenz does not continue acting in your body alone.
Therefore, Alluvia, which is a second line drug (with two drugs in one) was given to you for a week as “a lead out dose†to tail off Efavirenz, after which you will be put on a safer regimen.
Putting you on the next regimen will be done after monitoring that the levels of lactic acid in your body have normalised.
A safer regimen of ARVs such as Tenofovir, Emtricitabine or FTC and Efavirenz can now be got in a fixed dose combination as one tablet called Atripla, which is taken once a day at night.
Send your question on HIV to Health Editor, The New Vision.
P. O. Box 9815, Kampala
or health&beauty@
newvision.co.ug