Q and A

Question

I have a serious rash from starting treatment – should I stop taking my meds?

I am a 30 year old woman I got tested for HIV in 2009 and was found positive. In April 2010 I developed Kaposi’s Sarcoma but had only a few lesions. In December 2010 my CD4 count was 221 and I started ARVs, within a week I developed a very bad rash and they had to change my medication, I had been on this new drug for two weeks and I developed another rash which gets worse every day and I’m seriously considering stopping taking ARVs altogether because I feel like I was healthier without them and the rash is really affecting me, physically and emotionally. Please advice

Answer

Thank you for your question. I am sorry to hear you are having such a hard time taking the HIV medication. Many people experience side effects when starting medication. Some of these side effects lessen 2-4 weeks after starting the meds. If they continue then you should talk to your HIV doctor about changing your meds again until you find the right combination for you. You should not stop taking the meds or you will become sick very quickly and you could end up with resistance to some of the meds. This will limit your treatment choice in the future.

Although many drugs are linked to rash, the severity of rash and how long it lasts varies considerably. With some drugs, if you develop a rash during the first few weeks of therapy you must report this immediately to your doctor. This is because it can sometimes lead to very serious reactions. These drugs are abacavir (Ziagen, and in Trizivir and Kivexa), nevirapine (Viramune), efavirenz (Sustiva), etravirine (Intelence), fosamprenavir (Lexiva) and T-20 (enfuvirtide, Fuzeon).

Other rashes are more likely to be mild and disappear without treatment, or can be easily treated with antihistamine drugs such as cetirizine (Zirtek) or loratadine (Clarityn).

It would help me give you a more specific answer if you could tell me the meds you took previously and the ones you are on now?

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104 comments

  1. Simon Collins

    Hi Laticiai, a few people (about 1 in 20) get a rash with Atroiza that means they need to use an alternative treatment. Once the rash has got better, your doctor probably plans to suggest a new combination. Please talk to the doctor about which drugs will be used. It usually means using a different medicine – i.e. not Atroiza. Your response to the new meds is likely to be much better and your long term health should not be affected by the first rash.

  2. Laticiai

    Hi. I have just started my ART (atroiza). for the first 2 weeks it was fine. But in the third week I develop pink rash over the whole body. I consulted my doctor immediately and he told me to discontinue medication with immediate effect. How will this affect my condition?

  3. Simon Collins

    Hi Jetam, it is good to contact your doctor about any rash. Although often this can be mild, HIV meds can sometimes cause a serious rash. The doctor needs to decide based on either a detailed explanation, or better still, having seen the rash.

  4. jetam

    I have started taking ART since january 2017. And today i.e. 21 Dec., 2017, I have mild rashes. Is this serious? Please advice.

  5. Lisa Thorley

    Hi Talent,

    If you have a rash you need to discuss this with your doctor, and as soon as possible. Though it may be nothing, it could be something serious.

  6. talent

    I’ve just stared my ARVs, I’ve a really bad rash all over my body.

  7. Simon Collins

    Hi Milla, I am sorry for only just seeing your comment.

    With any rash – and especially a serious one – your doctor needs to see this in order to decide what to do. In general, any rash that covers more than 15% of your body and/or breaks the skin usually involves stopping the HIV meds to change to a different combination. This small break in treatment, to let your body recover, with be very safe, but your doctor needs to give you this advice.

    If your combination includes a drug called efavirenz, nevirapine or abacavir, these are likely to be the cause. Using different drugs when you restart is important. Do not restart with the old drugs.

    Please keep me know what your doctor says if you want to talk more – and I will reply straight away.

  8. milla

    I’m start 9 days my ARV drug and blisters worste too much that I cannot even eat rash all over my body I take it any more I skip a da i cry I went see the private Dr on sat and sunday is close Monday is not working I can stop for three days and go back to clinic , now I I only skip last night and this morning is like I want to continued before see the clinic what must I do help I leally I didn’t want to skip

  9. Lisa Thorley

    Hi Amanda,

    Though it may be nothing, its always important to have a rash checked out. Therefore, if you can please go and see your doctor.

  10. Amanda

    Hi Dr i have been taking my arvs for 8 days now Antrozia nd i think they contain efavirens was feeling dizzzy the first few days but feeling better now and ive been drinking lots of water. My problem now i woke up with red itchy small bumps all over my body except for my face should i be worried about this or must i immediately go to the clinic again on Monday.

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