Gout.... anyone get it from treatment?

[Rural_oz]

I have been on treatment for 2 weeks (Epzicom/Kivexa & Viramune) and have woken this morning with a really bad case of Gout.  Never had it before, any suggestions?

[anniebc]

Hi Oz

First of all welcome to the forums.

Gout is medical condition that is caused by elevated levels of uric acid in the blood, and can cause inflamation of the joints, this could lead to arthritis.

Gout is a very common ailment, and as far as I know is not caused by any of the meds you are taking, but someone with more experience about the meds will be able to advise on this...sorry I can't be of more help.

Hugs
Jan

[newt]

Unusual...but not a first...

There is this, perhaps the only, case report of relevance of uric acid related disorder from abacavir:

Abacavir-induced reversible Fanconi syndrome with nephrogenic diabetes insipidus in a patient with acquired immunodeficiency syndrome

The important point here is that the docs separated the nevirapine and abacavir in the combination and, unusually, uric acid increased/symptoms returned on rechallenge with abacavir but not nevirapine.

Elevated uric acid, and related conditions like excess lactic acid, are relatively common in people on treatment. More than half of people in the Swiss cohort with raised lactic acid levels had "gout arthritis".
Both can cause joint pain.

Arthritic pain in the 1st 4 weeks of this combo may indicate an adverse reaction to abacavir and/or nevirapine. I guess you had the HLA test for abacavir, so if it is that drug it is so very unlikely to be a serious reaction to that drug, but for nevirapine, in the 1st 8 weeks of using it, this would be a cue for me to telephone the clinic and ask for a point of view.

There's also the bloody annoying phenomenon of arthritis type conditions that appear post-treatment as people here, including me, will testify.

- matt

[Rural_oz]

Thanks for the replies.  Sunday here today, so I will contact my clinic tomorrow.  My Doctor did say that I propensity for gout when we first did tests to work out a drug regime.  I hope I don't have to change, because I have had little or no side effects from this combo at all.  Most sites recomment anti-inflamitories, but I am hesitant to use those today as I do not know how they would interfere with my meds.  Once agains thanks