Fever = Meds?

[LordBerners]

So I've had a fever of about 38 degrees centigrade (not sure what that means, but its the system they use here), for about 10 days, since a day or two after I began taking meds.  When I went into the doctor they did a chest X-ray and said it was clear, so tuberculosis, etc, is unlikely.  Isn't it likely that it is just caused by the medications?  I went off them for two days, and did feel better - now I'm back just on the Truvada, leaving the Sustiva alone, and the fever is back and strong.

On the Truvada alone I find I'm managing to eat a little, but food still tastes so strange.  I wish I knew someone who could confirm my tastes - like 'is this really incredibly salty, or is it just my imagination?'  Between that and constantly sending every meal back 1/3 eaten I feel like a crazy man.

[Andy Velez]

Have you spoken with your doctor about your persistent fever? Before you make any (mis)interpretations about the cause(s) and changes in your medications, that seems to me to the be the first place to start.

Keep us posted, please.

[LordBerners]

Have you spoken with your doctor about your persistent fever? Before you make any (mis)interpretations about the cause(s) and changes in your medications, that seems to me to the be the first place to start.

Yes, as I said in the introductory post, I went to see my doctor they did a chest x-ray and it was clear, apparentely eliminating a lot of things.  They really had no idea what it was, saying it could be the meds or something else.

[Andy Velez]

OK. Thanks for the clarification. It's still kind of vague to me and perhaps to you as well as to what to do about the meds. Were you given any specific directions?

Any other symptoms besides fever?

[LordBerners]

OK. Thanks for the clarification. It's still kind of vague to me and perhaps to you as well as to what to do about the meds. Were you given any specific directions?

Any other symptoms besides fever?

Yeah, the primary one is I have hardly been able to eat any food since I began taking the meds(lost like 12 pounds and feel soooo weak) - they leaned toward blaming this on the sustiva, but said it could be elements of truvada too.  They said lots and lots of Thai patients get severe anemia on this combo.

Their only recomendations were to try to take it anyway as 'the other options are worse'.   

[minismom]

We changed Mini from Susteva to Viramune (unsuccessfully) and the first thing that went was her appetite.  Kid could eat us out of house and home, started the new med and she barely ate at all.  She also complained about a headache, which she's never had before.  Her doc said it was probably due to the meds and could take a while for her body to adjust. 

Of course, then she developed an allergy and we quit the med...but that's for another thread.

Hope you feel better very soon.

Mum

[newt]

If the symptoms got better on stopping Truvada and started again on re-taking this drug, its a good bet the this is related to the Truvada, probably the tenofovir it contains. And possibly including a bad effect on your kidneys. The symptoms you describe would be mostly consistent with this possibility but are not conclusive in themselves -- so please go get your kidneys checked. 

Anaemia from Truvada would be a rather serious (but very rare in Western patients) kidney-related event.

There are other drugs. While they too may have side effects, they may not be this bad.

An x-ray is not diagnostic for TB, especially TB outside the lungs.

- matt

[LordBerners]

If the symptoms got better on stopping Truvada and started again on re-taking this drug, its a good bet the this is related to the Truvada, probably the tenofovir it contains.

Well, they are still a shadow of the severity they were before when I was on the Sustiva as well.

And possibly including a bad effect on your kidneys. The symptoms you describe would be mostly consistent with this possibility but are not conclusive in themselves -- so please go get your kidneys checked.

Well, I wonder why my doctors didn't suggest this?  Or do it while I was there.  They seem somewhat less than competent.  I won't be able to go back for weeks.

I guess being study docs they just want people to try to keep getting the free meds and stay in the study, but sometimes quality of life matters too.

Anaemia from Truvada would be a rather serious (but very rare in Western patients) kidney-related event.

Well I have no idea if I have 'anemia', or even what that is precisely.  I just couldn't eat, lost a lot of weigh quickly, and feel very weak.

There are other drugs. While they too may have side effects, they may not be this bad.

An x-ray is not diagnostic for TB, especially TB outside the lungs.

Thanks.. didn't know that about TB.  I think the best thing is to drop the medications for at least a couple months, or maybe a lot longer, try to recover my strength, and start again when on holiday (it is not a good idea to begin these side effects when trying to work, not to mention ones colleagues become suspicious when one suddenly becomes very listless, ill, and shockingly gaunt apparently overnight!).

[Jacques]

Milord,
Could we know what your numbers are (Cd4, Vl) ?

Jacques

[LordBerners]

Milord,
Could we know what your numbers are (Cd4, Vl) ?

Jacques

Sure, I have had justtwo sets of numbers, and if I recall correctly the first set around 6 months ago were 300 CD4 16.5% VL 750,000.

Three months ago - 304 CD4, I don't remember the percentage, and VL 100,000.

So basically the same, high viral load.

[Jacques]

Ok. I was wandering that perhaps an IRIS (immune reconstitution syndrome) could be related to your symptoms. But your CD4 at 304 put you out of this eventuality.

By the way, is there a possibility that you could see  an other doctor an have a second opinion?

Jacques

[LordBerners]

Thanks Jacques, yes I figured that my immune system was still a bit to healthy to be reconsituting itself like happens to some people. 

The docs I'm seeing are my second group, and they are better than the first, which were at a very mercenary expensive foreigner-oriented private hospital.  Overal I have to admit I feel much more comfortable with foreign doctors for serious things here in Thailand, and that isn't always easy to find.

To update, yesterday I experienced a period of a few hours when I felt normal!  The fever broke, normal appetite.  Wow, I felt like a human being!  I was in a big dirty bus station in Bangkok when it happened but the place looked beautiful.

Today I feel a little worse, but I'm pretty well convinced now that it was the Sustiva that made eating so difficult, not anything in the Truvada combo, which I'm still taking for a few more days.

[John2038]

LordBerners, one time in my life, long time ago, I went to the McDo and ordered a conventional meal.
I found the french fries so salty and with a so bad taste that I goes back to the counter and said:

- Have you taste the french fries before serving them ??
- The guy served me a new portion. I tried them again in front of him and still found them extremely salty and bad tasting.
He tried, and said:
- They are perfectly normal. Another employee tried and said the same.

For a week, it seems that I have lost the tasting sens.
I was not poz at this time, and every thing come back alone to normal few days after.
True story.