POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: dusty99 on November 14, 2008, 08:43:07 am
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I may be starting Atripla next week, my numbers were good, and then they went down to 300 with a VL of 68k, so my doc wants me to start meds, I don't want to, but, well if it has to be, it has to be. At any rate a few things concerned me when I read up on it. It seems Atripla can cause lipodystrophy which with my current body make up, would look good in my face, legs and arms, but I have a bit of a gut and don't need any more there. The big issue, is it can cause diabetes, and I am already pre-disposed to it as it runs in my family. I will be talking this over with my doc, but it does concern me. Has anyone had any issues other than the dreams and such??
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Hi Dusty --
Just wanted to clarify a couple things.
First off, it's really not at all clear if Atripla is associated with an increased risk of lipodystrophy. There's been one study (ACTG 5142) suggesting that Sustiva (a component of Atripla) may cause fat loss than Kaletra, but it's not at all clear how significant this finding really is -- it hasn't been duplicated in another major study and, besides, the fat loss seen in Sustiva-treated patients in ACTG 5142 wasn't profound.
As for Atripla being associated with lipohypertrophy -- abnormal gains of fat deep within the body (visceral adipose tissue) -- I really can't point you to any studies suggesting that this occurs with this drug. This tends to happen in people whohave a long history of HIV disease and have been on therapy for several years (it also seems to be more common among those taking a protease inhibitor, notably a regimen containing Norvir).
The short end of it is that I wouldn't worry too much about experiencing lipodystrophy while on Atripla. HOWEVER, you should note that people sometimes experience some weight gain upon starting treatment. Just as growing older tends to be associated with a bit more flesh here and there, so does the "return-to-health" associated with HIV treatment. In other words, if you start to see you waist line thickening, don't necessarily assume its lipodystrophy.
As for diabetes, slight increases in fasting glucose levels have been seen in some clinical trials evaluating the three drugs in Atripla. However, this tends to be a bigger concern with the Norvir-boosted protease inhibitors. I would think that regular monitoring of your labs -- fasting glucose levels every three months -- would be adequate to watch for this while on treatment. And be sure to discuss this concern with your health care provider.
As for the vivid dreams and other possible central nervous system side effects of Atripla, I know that some have found these challenging whereas others barely even felt them. I hope others will chime in with their experiences -- if not, there are numerous threads in these forums started by people with similar questions. We also offer up our "Tips & Tricks on Taking Sustiva (http://www.aidsmeds.com/articles/SustivaTips_7550.shtml)" lesson.
Best of luck,
Tim Horn
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Dusty, I went through the same anguish when my doctor wanted me to start meds for the first time (Atripla). I am now very happy that I listened to her. I must say, that after 2 months on the medication, I have had some thickening in my waist line but I believe as Tim does that it is just that my body is returning to a healthier state. I am also a middle-aged man and have always battled my waist line even before I was positive. So far, I have seen no changes in my face, arms, legs or butt.
As for other side effects, I had really cool dreams the first night, a little anxiety and I was drowsy in the mornings for the first week. Side effects vary from person to person but they seem to go away for most everyone after the first 2 to 3 weeks. Now, I am just fine. In fact, I was almost giddy at my last doctor's appointment, as I was very pleased with my results and the fact that I don't even notice the medication. Give yourself a few weeks to adjust and then you can resume a normal social life. Just carry a pill on you if you are going to be hanging out with friends. That way, if you can't make it back home because of quickly made plans, you don't have to worry about missing your dose.
It is definitely more important for you to be healthy and in control of the virus. If you don't already do this, eat healthy and get regular exercise. You will do fine.
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Thanks for the feedback, I do hope for more comments from others experiences, I was beginning to wonder if anyone cared about my questions, as there had been some 40 views and no comments. Anyway, any and all comments about Atripla, even if they are second hand from people who have friends who have shared with them stuff that they experiences. thanks in advance. I am still pretty new to this and even though I know the meds will be better for me, my emotions are having a hard time with having to do so. I have always been a self sufficient person, and havent had to rely on people for anything until recently. So in addition to being HIV+ I have had to change my whole life, on so many fronts. I have only been diagnosed since Mar 08, thanks again
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I want to say thank you to everyone. I've just joined the forum. I was recently diagnosed and have completed my blood work. I had my initial appt with my ID Dr, which I must say really put me at ease. I have my follow-up appt next week and we will go from there. You all mention the questions to ask the Dr. I have been making a list with all your information/input. Thanks again for all the great information on some of these drugs and common side effects.
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Hi Dusty,
I have to admit I was a bit shocked that you're thinking of starting meds already with the numbers you have. Your CD4% has been consistently very high. The CD4 absolute can and in most cases, will, bounce around. If you wait until your next lab results, I think you'll likely find your absolute has gone back up. Three results can hardly show any meaningful trend.
I've been poz over eleven years now, and monitoring my numbers for nearly eight. If I panicked and started every time my CD4 absolute went a bit south, I'd have been on meds for years now. I'm still treatment naive.
Of course, it's absolutely your call (in conjunction with your doctor) but I'd recommend you hang on for your next set of labs, at least. You could well be pleasantly surprised by your numbers.
By the way, if you're wondering about the significance of your CD4%, read the T-Cell (aka CD4) Lesson (http://www.aidsmeds.com/articles/TCellTest_4727.shtml)
Ann
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ann,
Thanks for your comments, I was concerned about that as well, and asked my Dr. about it, and she told me that with the VL being so high that that was an issue for the panel that meets about the HIV patients. (VA hosp) I didnt really want to start either, and now with the standards being raised, they want me to start. and recently with other stuff happening to me, it may be the best way to go. I am still new, so I really don't know whether it is the best choice or not, but going on the advice of my Dr. and the panel and my partner, I am probably going that route. Tomorrow's visit, I will have a better picture.
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I started Atripla in June. The first week was tough. Anxiety, achiness, and just feeling unwell. After 1 week the side effects were gone, and now I don't even know I'm taking it. Maybe a little groggy in the morning, but hell I'm 47. I never had the vivid dreams. 100% adherence all within 1 hour every night.
If you look at my numbers, CD4 511, 29%, Vl 47,500, my doc started me early too, But you'll notice that's the direction doctors are recommending.
My doctor said since I was educated and motivated there was no reason for me not to start.
I am really glad I did. Undetectable and good CD4 counts
Good Luck, You'll be fine.
Remember you will be doing something to control the virus, the virus won't control you.
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Dusty,
As you're reluctant to start, I would once again recommend waiting for at least another lab result. Your viral load isn't really all that high - mine's been higher from time to time. Just because it's gone up doesn't mean it won't come back down on its own. It can bounce around just like the absolute CD4, only in reverse, if you see what I mean.
Again, it's absolutely your call. I'm recommending you take a wait-and-see approach for now, as you are in NO immediate danger. I'm recommending this approach because if you're not ready, heart and mind, to start meds, chances are your compliance will end up suffering and you dont' want that as it can lead to resistance issues. These meds are a BIG committment once you start them.
Good luck with whatever you decide.
Ann
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Well, after much conversation with my doctor and others I did start on Atripla last night, and so far, no real effects to speak of. I hope the 1st night is the worst when taking these sorts for medications. My reservations for starting meds, was one of feeling weak, I have always been one who always was self sufficient and never had to rely on others or things to survive. I know, it's a macho thing, but it was there, now, I know in my head the meds are the best thing for me, but my heart saw it as being weak. Now, I have to continue, there is no going back. At any rate, there you have it, I will pass on any experiences I may have with this med for the benefit of those who will eventually be going on this one.
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Well, the 2nd night was interesting, my body temp rose quite a bit but no fever. Had a weird dream but I expected that at some point I would. Other than that a little dizziness on both days. I do think it is at least temporarily it is messing with my blood pressure, as I have been a little light headed when working, but no bad symptoms other than what I have mentioned.
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Yes, Dusty, that dizziness or light-headedness will become non-existent after a few weeks. Just ride it out. As for the body temp, just keep in mind that your body now has a new tool to fight the virus and you will experience adjustments as your body returns to a healthier state.
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Yes, Dusty, that dizziness or light-headedness will become non-existent after a few weeks. Just ride it out. As for the body temp, just keep in mind that your body now has a new tool to fight the virus and you will experience adjustments as your body returns to a healthier state.
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Thanks for the information on the "dizziness or lightheadedness" PositivelySouthern. This is the only side effect I'm dealing with after I wake up. Been on Atripla since last Thursday, Nov 18 and will see if this is only temporary, while my body adjusts.
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well, been a week on meds, and very few side effects, I have found that I need to eat more while I am adjusting, as that was the worst of the side effects, being that I got extremely disconnected, and dizzy when I didn't eat in a timely manner. It would also affect my mood when that happened. Otherwise, my side effects were very minimal, I am having very vivid dreams, but I can't remember what they are when I wake up, except the rated X ones with the bf. Otherwise, all good.
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Dusty,
Been on Atripla for just over a week now. No side effects and have been sleeping just fine. Feel great during the day. Only side effects I've had were (1) good vivid dream the first night (can't remember my dreams though) and then (2) dizziness until I ate breakfast the following morning.
I just posted a question with regards to taking Atripla on an "empty stomach". I can't seem to find the reasons for this ....
Chime in if you can.
Later
jayjax
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Me too, I have been on Atripla since Nov.26,2009, I have experience no side effect yet, I really hope I don't. I hope it do what it is expected to do, cause I need to get my hiv virus under control in order to deal with this hcv virus. I know I am in for a long haul.
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Well, everything has been going good, it would appear that Atripla is definitely a well tolerated medication for HIV, I have only heard of one person whom it did not work for, (here locally, a friend of mine) so he is off this med. Otherwise, there have been no real issues to speak of, I have only had what I mentioned before with dizziness, and such like that, the only other thing that came along was a very light rash over my chest, but again, not an issue, it wasn't itchy or anything like that. So, moving on with the med and will find out around 16 Dec 08 when the pull my blood work to see where my numbers are. Will keep you advised when that happens.
Edit: forgot to mention that at the moment, it does seem that my heart rate is up a little, hopefully this will drop back down after awhile