ARVs making my brother sick
Dec 07, 2008
MY brother, who is HIV positive, was started on ARVs three weeks ago because his CD4 count was very low, even though he had no serious complaints.
Face HIV with Dr. Watiti
Dear doctor,
MY brother, who is HIV positive, was started on ARVs three weeks ago because his CD4 count was very low, even though he had no serious complaints. We bought for him two types of ARVs called Combipack and Efavirenz from a friend who said he had been on them for two years and they had helped him. My brother has, however, become so weak now and his eyes are yellow! What should we do now? Should he stop taking the ARVs?
Mike
Dear Mike,
ARVs should be initiated by a health care giver with experience in antiretroviral therapy (ART) after a patient has undergone adherence counselling in order to minimise mishaps like what your brother has had.
ARVS should never be bought across the counter or from another patient. The combination your brother was given is wrong because Combipack is a fixed dose combination of three drugs namely: Zidovudine, Lamivudine and Nevirapine.
This is a full regimen and should never be used together with Efavirenz. This is because Nevirapine and Efavirenz belong to the same class of ARVs known as none nucleoside reverse transcriptase inhibitors (NNRTIs).
These are known to affect the liver and when used together, the effects are worse.
This is the most likely cause of your brother’s ill health and yellow eyes. The drugs should be stopped and the patient reviewed by a doctor who should do tests to check the integrity of his liver and kidneys.
They can be restarted later when he has stabilised but the two (Nevirapine and Efavirenz) should preferably be avoided.
He should be registered with a credible and accredited ART centre because this is the only way to avoid being mismanaged. The biggest hindrance to people living with HIV (PLHIV) being registered with a credible HIV treatment centre is stigma.
Stigma creates fear in PLHIV and so they end up in the hands of unscrupulous people who often do not know what to do.
Dear doctor,
MY brother, who is HIV positive, was started on ARVs three weeks ago because his CD4 count was very low, even though he had no serious complaints. We bought for him two types of ARVs called Combipack and Efavirenz from a friend who said he had been on them for two years and they had helped him. My brother has, however, become so weak now and his eyes are yellow! What should we do now? Should he stop taking the ARVs?
Mike
Dear Mike,
ARVs should be initiated by a health care giver with experience in antiretroviral therapy (ART) after a patient has undergone adherence counselling in order to minimise mishaps like what your brother has had.
ARVS should never be bought across the counter or from another patient. The combination your brother was given is wrong because Combipack is a fixed dose combination of three drugs namely: Zidovudine, Lamivudine and Nevirapine.
This is a full regimen and should never be used together with Efavirenz. This is because Nevirapine and Efavirenz belong to the same class of ARVs known as none nucleoside reverse transcriptase inhibitors (NNRTIs).
These are known to affect the liver and when used together, the effects are worse.
This is the most likely cause of your brother’s ill health and yellow eyes. The drugs should be stopped and the patient reviewed by a doctor who should do tests to check the integrity of his liver and kidneys.
They can be restarted later when he has stabilised but the two (Nevirapine and Efavirenz) should preferably be avoided.
He should be registered with a credible and accredited ART centre because this is the only way to avoid being mismanaged. The biggest hindrance to people living with HIV (PLHIV) being registered with a credible HIV treatment centre is stigma.
Stigma creates fear in PLHIV and so they end up in the hands of unscrupulous people who often do not know what to do.