HIV and steroid

[jonnylingo]

For patients with HIV, being treated, I've typically withheld steroid because of immunosuppressant effect. I'm curious if that is reasonable, or if you all have other thoughts regarding this.

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[SeniorWrangler]

Using a lower dose is a good idea.
Here's a case report of Cushing disease in a patient on Ritonavir who got triamcinolone in an ESI:
https://cid.oxfordjournals.org/content/47/12/e97.full

 

[olafa]

c/i in CD4 >200 for elective procedure, judicious use is appropriate if stable and no other active infection, (as w other immunocompetent pts) I always check w treating ID and get last CD4.

 

[bronchospasm]

Consulted ID for a patient last year and was told that it was OK to use 10 mg dexamethasone if CD4 count was greater than 200