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Hi Doctor, My Mother Had Second Delivery In 1989. She
Question: Hi Doctor,
My mother had second delivery in 1989. She was needed blood transfusion. During that time she got infected with HIV. HIV was detected in 1997. She had problems for about 2 years. After that she got normal. During September 2015 she again had problems of muscle pain and all. From that time she is on medication. Doctor gave her Ritomune & Lamivir. Symptoms eased during that time. But after some time she used to have pains in body & felt weak. Doctor changed her medicines after some time. Last report of cd4 was done in 20.05.2020.
CD4 ABSOLUTE COUNT - 172
CD4 PERCENTAGE - 21.65
VIRAL LOAD WAS DONE ON 12.06.2020
HIV-1 VIRAL LOAD (QUANTITATIVE) - 1861 copies/ml
Log Value - 3.27
She has been diagnosed with TB in month of May.
She is on AKT medicines for TB
Also her HIV medicines at present are
Lamivudine & Tenofovir Tablets
Dolutegravir Tablets.
She also has acidity problem.
From last few days she is having her vein swollen & also she has joint & muscle pains. Also there is weight loss of 2.5 kgs in last 4 months (from 56.9 in May 2020 to 54.4 in August 2020)
Last year October her weight was 64 kgs
You are requested to inform
1) Are these medicines proper
2) What to do for joint & muscle pains. (do these happen with these disease)
My mother had second delivery in 1989. She was needed blood transfusion. During that time she got infected with HIV. HIV was detected in 1997. She had problems for about 2 years. After that she got normal. During September 2015 she again had problems of muscle pain and all. From that time she is on medication. Doctor gave her Ritomune & Lamivir. Symptoms eased during that time. But after some time she used to have pains in body & felt weak. Doctor changed her medicines after some time. Last report of cd4 was done in 20.05.2020.
CD4 ABSOLUTE COUNT - 172
CD4 PERCENTAGE - 21.65
VIRAL LOAD WAS DONE ON 12.06.2020
HIV-1 VIRAL LOAD (QUANTITATIVE) - 1861 copies/ml
Log Value - 3.27
She has been diagnosed with TB in month of May.
She is on AKT medicines for TB
Also her HIV medicines at present are
Lamivudine & Tenofovir Tablets
Dolutegravir Tablets.
She also has acidity problem.
From last few days she is having her vein swollen & also she has joint & muscle pains. Also there is weight loss of 2.5 kgs in last 4 months (from 56.9 in May 2020 to 54.4 in August 2020)
Last year October her weight was 64 kgs
You are requested to inform
1) Are these medicines proper
2) What to do for joint & muscle pains. (do these happen with these disease)
Brief Answer:
Drug interaction and monitoring should be looked into with more care.
Detailed Answer:
Hi,
Welcome to ASK A DOCTOR through HCM.
Thanks for posting your query.
She was known HIV POSITIVE INDIVIDUAL since 1997 onwards and on ART since from 2015 only... Gross negligence.
Ritomune and Lamivudine (dose not mentioned the dosage) alone should be an ideal treatment in the absence of a NRTI backbone.
Her CD4 count on 20-5 20 was 172 with CD4%, 21.65% So the choice of ART did not seem to be effective and the monitoring was not good.
Now she also got affected with Tuberculosis (reveals poor immunity)
Now she is on TENOFOVIR+LAMIVUDINE+ DOLUTEGRAVIR. This is a good combination and recommended as a firstline therapy by many guidelines.
But here also what type of ATT she is taking, is not mentioned. Certain ATT drugs could interact with Dolutegravir. It has to be adjsuted accordingly.
You told her weight was 64 kg. Is it improving or declining? (previous weight was low only)
Regardig her symptoms.... She is 56 year old. Possiblity of co morbidities like arthritis could be there. A menopausal lady is likely to go for osteoporosis (Loss of calcium from bones). This could be aggravated by Tenofovir. Serum calcium and Vitamin D3 levels should be seen.
She could be tired of medicines and the symptoms could be psychological. A proper monitoring is necessary.
Dr S.Murugan
Drug interaction and monitoring should be looked into with more care.
Detailed Answer:
Hi,
Welcome to ASK A DOCTOR through HCM.
Thanks for posting your query.
She was known HIV POSITIVE INDIVIDUAL since 1997 onwards and on ART since from 2015 only... Gross negligence.
Ritomune and Lamivudine (dose not mentioned the dosage) alone should be an ideal treatment in the absence of a NRTI backbone.
Her CD4 count on 20-5 20 was 172 with CD4%, 21.65% So the choice of ART did not seem to be effective and the monitoring was not good.
Now she also got affected with Tuberculosis (reveals poor immunity)
Now she is on TENOFOVIR+LAMIVUDINE+ DOLUTEGRAVIR. This is a good combination and recommended as a firstline therapy by many guidelines.
But here also what type of ATT she is taking, is not mentioned. Certain ATT drugs could interact with Dolutegravir. It has to be adjsuted accordingly.
You told her weight was 64 kg. Is it improving or declining? (previous weight was low only)
Regardig her symptoms.... She is 56 year old. Possiblity of co morbidities like arthritis could be there. A menopausal lady is likely to go for osteoporosis (Loss of calcium from bones). This could be aggravated by Tenofovir. Serum calcium and Vitamin D3 levels should be seen.
She could be tired of medicines and the symptoms could be psychological. A proper monitoring is necessary.
Dr S.Murugan
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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