Background: HIV-associated nephropathy (HIVAN) can progress to end-stage kidney disease (ESKD), complicating antiretroviral therapy (ART) management due to renal dosing requirements, particularly for lamivudine.
Case Presentation: We describe a 29-year-old male with ESKD secondary to HIVAN, who developed debilitating headaches after initiating fixed-dose ART (abacavir /lamivudine/ dolutegravir). Due to lack of monotherapy in Tanzania, dose adjustment was not possible. The patient’s quality of life declined, and ART adherence suffered.
Management and Outcome: After acquiring lamivudine monotherapy abroad, renal-adjusted dosing (75 mg/day) led to complete headache resolution and improved adherence within two weeks. Symptoms did not recur over six months.
Conclusion: Renal-appropriate ART dosing is critical in ESKD. This case illustrates how fixed-dose regimens in low-resource settings can lead to avoidable side effects and adherence challenges. Policy reform is needed to enable individualized ART access.
International Journal of Advanced Research in Medicine
