about HIV/epi-treatment
Posted: Aug 27, 2007
QUESTION:
Dear collea
gue,my problem is about a 30 years old woman HIV+ from 3 years, on HAART first with Fortovase/changed with crixivan because of haematemesis,and crixivan was changed because of nephrolithiasis.Now she is on 3-nukes therapy for 2 years:Zerit+Videx and Ziagen.her CD4 are about 800/ml and VL is between 1000 and 10000. Conserning epilepsia- she has transient evidences of amnesia and her treatment include revotril+depakine chrono.My question is what to change in her ART and second question- anti-epi therapi
thank you in advance
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RESPONSE FROM: 
By her CD4 cell count, your patient is doing well with her HIV infection. Her viral load is not completely supressed and that can cause trouble with resistance over time.
Much depends on what HIV medications are available to you. In addition, you do have to mind the interactions between the HIV and epilepsy medications. However, I do not think there should be major interactions between revotril (diazapam) or depakote and most protease inhibitors.
If you can identify a new protease inhibitor such as Kaletra, I would consider adding this to her regimen and then perhaps take her off of the Videx.
DW
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