Photosensitivity on Atripla?

[DRS]

Hello...I was diagnosed as poz in September of last year and started Atripla in October. My viral load was 116,000 at the time of my diagnosis. I have been taking Atripla, faithfully every night since. My last blood work, about 2 weeks ago, showed my viral load at 58. My question: has anyone who is on Atripla experienced any photo sensitivity? Twice in the last 5 weeks I was traveling to areas where there was a lot of sunshine ( we don't have much of it in Wyoming, lol) and within an hour or so of being outside I developed an itchy rash on any of my exposed skin: face, arms, etc. it wasn't a sunburn, I know the difference. I was able to get temporary relief from the itchiness by taking Benedryl. I asked my dr about it after the last time it happened, and she was curious about it too. But to be safe, she ran a syphilis blood test which came back non reactive. Next step: the dr is considering a change in my meds. Thoughts? Similar experiences?

[RapidRod]

I was on it for almost 7 years, outdoors in the sun and never had anything like that happen. I would discuss it with your ID doctor.

[Ann]

It seems it is a rare, but possible reaction. In one study of 1519 people taking Atripla, two had photosensitivity and on the NHS website (the UK's health system), it is listed as RARE; more than 1 in 10,000 people. (For perspective, the next category up is UNCOMMON; more than 1 in 1,000 people.)

In trying to pick out which of the three drugs in Atripla could be the culprit, it looks as though it could be any one of them. (They are Sustiva [aka efavirenz], and the two components of Truvada; tenofovir and emtricitabine.) For example, in one study of 10,600 people on Truvada, twelve of them had photosensitivity.

My guess would be that it's the efavirenz component though. I think it would be the most likely culprit as it's more well-known for reactions involving the skin than the other two components.

If you want to research this further, google the three components of Atripla (separate searches) along with "photosensitivity" and you'll get plenty of food for thought.

And as Rodney says, make sure you discuss this with your doctor. If you've researched it a bit first, you will be able to have a more in-depth conversation with your doctor about it.

Also, are you on any other meds? Many can cause photosensitivity, including some antibiotics. It might not be the Atripla at all, or it might have been the proverbial straw if you're on some other med that can also cause photosensitivity.

Coping strategies include using a high-factor sun-block, and covering up by wearing a hat, long sleeves and trousers when in the sun. Light-weight, light-coloured fabrics will help keep you cool - that's why desert peoples tend to wear white. Trying to get a tan would be off the table, unfortunately.

Hope this helps.
Ann

[DRS]

Thank you for the input. As I said, i have shared my concerns with my Dr, and since the blood work didn't show anything abnormal, she wants to consider changing my meds. I tend be be quite on the fair complected side, is always take precautions in the sun. We'll see what she says on Friday.

[Ann]

Please keep us posted - your experiences with this may end up helping someone else. Thank you and - good luck!

[newt]

I see no reason why not, efavirenz activates the same part of the immune system that produces rashes, and some are more prone to this than others.

- matt

[DRS]

So...I had my check up with my dr today concerning the rash....she determined it is "solar dermatitis", a side effect of the efavirenz in the Atripla, thus marking me as one of the small handful out of 10,000 that experience photo sensitivity while taking the med. Yay for me! So, I will just have to take extra precautions while in the sun, which will be fun for my birthday trip to Puerto Vallarta in July!

[Ann]

Wouldn't it make more sense to switch to a combo that doesn't contain efavirenz? Particularly as you're going to celebrate your birthday in the sun?

[DRS]

Yes, it would, but dr and I are both hesitant to switch just yet, especially for how well the Atripla is working for my cd4 count and viral load. We are keeping it as a possibility however.