TB and HIV Thailand

[ratcat]

Hi everybody.  I'm looking. For some input regarding TB medication side effects issues with A HIV coinfected patient.  My Thai girlfriend is in big trouble, experiencing daily fevers, fatigue, weight loss, rash.....u name it, she's got it.  Other underlying infections have been ruled out already.  Test dosing is apparently not an option here.  I strongly suspect severe allergic reaction to her meds and drug induced hepatitis.  Anybody know any good resources here in Thailand.  Any input welcome.  I've done a ton of research but any more input will help.  Thanks

[ratcat]

Adding to this discussion, her cd4 hovers between 250-350, she is not on ART yet, just completed 2 months of Rimstar ( standard 4 medicines combined) and has started rifampicin and INH now for the next 4 months.  An ID specialist here suggested that her dose could be to high but I think that there is more to it.  Getting the doctors here to change her regimen is like pulling teeth.  Any input appreciated.

[xasxas]

Well - I don't have much to say in terms of helping you diagnose the problem but I would recommend two options:

1) If you can afford to and are close to Bangkok, I would recommend going to a private hospital / clinic for a second opinion.  There are some very good ID specialists in Bumrungraad and Samitivej (spelling).   You can lower the cost by getting the requisite blood tests done at the Anonymous Clinic in Bangkok.

2) Starting ART can only help as it will allow the immune system to start recovering / rebuilding itself.  TB and other opportunistic infections become a lot more problematic and harder to fight when your immune system is impaired.

I hope your girlfriend feels gets better. 

[ratcat]

Thanks xasxas. Exactly my plan.  I already consulted with an I'd specialist last week and ill bring her here to visit next time.  I use the anonymous clinic myself.  It's her fault for not taking the right precautions.   Won't make that mistake myself...