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| SPECIALIST ANSWERS
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Question |
8 year old male patient known case of retro viral positive , whose count was only 5 and was put on zidovudine,lamivudine and stavudine for 2 years. i knew that the combination of zidovudine and stavudine should not be used..so immediately i changed to zidovudine , nevirapine and lamivudine.........i wanted to change 2 drugs but i changed 1 drug onlyas pt was not affordable.pt was alright for 1 year but now he is decreasing weight from 25 to 21 now..but symptom free..please suggest me what iam suppose to do...
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Answer |
Dr Ira Shah replies:
You must rule out the following:
Treatment failure. Do a CD4 count and see for clinical as well as immunological failure.
2. Rule out drug reaction. Since the child was on zidovudine and stavudine together and is presently on AZT and 3TC, then rule out metabolic problems such as hypertriglyceridemia, hypercholesterolemia, lipodystrophy, diabetes mellitus, lactic acidosis and hepatic steatosis.
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