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Does ART Cause Pancreatitis?

Posted on Mon, 14 Dec 2015

Question: Hi My Name is XXXXXXX XXXXXXX

5 years Back i got HIV . And 3 years back i started ART treatment. One year back i got Pancreatitis. At that time doctor told stop alcohol and stopped alcohol and i stated ART again. Now Recently i got Pancreatitis recurrently two times. At this time i got Lung infection PCP. Because of this my CD4 count decrease to 100. Now Doctor told which ART medicine won't cause ART use that medicine only. Below are ART Medicines i used earlier. Please Help me on this issue.

1. Lamivudine,Nevirapine and Zidovudine Tablets IP(I used this Nearly 2 years)
2.Forstavir-3(I started this only one week back).

Please Help me on this issue.

Answered by Dr. Sheetal Verma (3 hours later)

Brief Answer:
Forstavir is better.

Detailed Answer:
Hi
Thanks for your query at HCM.
I understand your concern and situation.

Forstavir has efavirenz/emtricitabine/tenofovir is an antiviral combination of 3 reverse transcriptase inhibitors. It works by slowing the growth of HIV, the virus that causes AIDS. It is better than your previous medicine and has less side effects. I suggest you to continue it as it has been found to be better in various clinical trials. Practice barrier method for intercourse, maintain body hygiene and practice hand washing. Monitor viral load regularly.

Take care
Rating and review will be appreciated.
Dr Sheetal Verma

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Sheetal Verma (10 hours later)

But this medicine making the problem. When he used this medicine he is getting Abdominal pain. This is also one of the side effect.

hyperglycemia, abnormal dreams, nausea, increased liver enzyme, swelling of eyes and lips., abdominal pain, dyspepsia, vomiting, insomnia, Very Common: Headache, itching and rash, hypertriglyceridemia, diarrhea, increased creatine kinase.Common: Neutropenia, allergic reaction, dizziness, weakness and pain.Uncommon: Anemia

Please suggest me which is not causing abdominal pain.

Answered by Dr. Sheetal Verma (2 hours later)

Brief Answer:
See details.

Detailed Answer:
Hi

Before attributing any symptoms to side effects one needs full evaluation. Do not take the medicine empty stomach. Sometimes body gets used to medicine in few weeks. Take bland and non spicy diet. I would suggest the patient to get stool microscopy, culture and sensitivity test done. Antacids will be beneficial and drink plenty of water.

Take care

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Sheetal Verma (1 hour later)

I would like to send all reports to you. I haven't taken any medicine on empty stomach.I am not taking any spicy food am i am taking soft food only.please have a look into it. please suggest me best medicine for me. can i send medical reports to u? Or please tell me which report are help for full evolution.

Thanks & Regards, XXXXXXX

Answered by Dr. Sheetal Verma (20 minutes later)

Brief Answer:
Yes send the reports.

Detailed Answer:
Hi

Yes you can send all the reports.

Take care

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Sheetal Verma (7 hours later)

Please find the attached Reports Give me your r valuable answer. Please suggest me best medicine. I am begging u. Please ................................

Answered by Dr. Sheetal Verma (23 minutes later)

Brief Answer:
Take truvada or fostavir.

Detailed Answer:
Hi

Your reports suggest liver and pancreas involvement as the levels are deranged. I would suggest you to visit gastroenterologist for proper physical examination. Also visit a pulmonologist to get respiratory assessment done. I would suggest you to take truvada or fostavir.

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sheetal Verma (12 hours later)

Please tell me dose and how should i take dose with empty stomach ? or with out empty stomach. Please guide me some suggestions.

Thanks & Regards,
xxxxxxxxxxxxx

Answered by Dr. Sheetal Verma (1 hour later)

Brief Answer:
Stop ART for 15 days.

Detailed Answer:
Hi

The drug comes as fixed dose combination. Take efavirenz/emtricitabine/tenofovir by mouth on an empty stomach at least 1 hour before or 2 hours after eating. As your enzymes are deranged I would suggest you to stop ART for 15 days. Get investigation done before starting the drug again. Visit a physician who can examine you physically. If enzymes still are elevated then we might have to find alternative way.

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sheetal Verma (3 minutes later)

But my CD4 count is 94. If i stop is it makes any problem. Please suggest me.

Answered by Dr. Sheetal Verma (5 minutes later)

Brief Answer:
CD4 too low. Continue treatment.

Detailed Answer:
Hi

Okay I see that. If CD4 count is that low then continue the treatment. Stay in follow up. Get the test done at intervals to evaluate enzyme levels. Take enzyme supplements and liver tonics to support liver and pancreas. If you develop any problem report immediately. Take medicine with one full glass of water.

Take care

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar