I've been a bad boy...

[atlantabro]

I just got a call from my ID doc. She's requesting a genotype test because my VL has gone from undetectable to 6417. My CD4 has gone from 423 to 469, which is good. What she doesn't know is that I stopped taking my meds (Atripla) since February. I've been having a lot of GI issues and personally felt that the Atripla was adding to the problem. Plus the dreams/nightmares caused by Atripla became quite unbearable. So I stopped. What's weird is that while on Atripla, my CD4 counts hovered around the 350 mark, but have managed to go up when I stopped taking it. Is that normal?

I don't know what to do. Naturally, I want to ensure that I maintain optimum health, but I'm scared that if I start taking Atripla again, my GI issues will be further aggravated by the meds and the unwanted nightmares will return. I'm also scared that I may have built up resistance to the Atripla. We'll see what the genotype test says.

I will call my doc and let her know that I've stopped taking the Atripla. I'm sure I'll get a mini-lecture, but I hope that we'll be able to figure out a plan so that my CD4 numbers increase and VL goes undetectable once again.

[newt]

So much for the lecture...

If your gut/head was screwed then maybe this is just another way of getting into a new combo...there's ways of changing treatment and then there's ways.

Personally, I would not go back on Atripla regardless of the genotype results. The risk of NNRTI resistance from stopping Atripla outright is very high, cos the efavirenz in Atripla hangs around at low levels for a very long time. 

Time to move on to a boosted PI, or perhaps Isentress.

Using the other two drugs in Atripla, tenofovir and FTC should still be OK though.

On the CD4 the difference between 350 and 450 in such a short space of time on one test is not significant enough to draw conclusions. Bear in mind, in the short term, taking the drug pressure off your virus activates your immune system, which could mean more CD4 cells in your peripheral blood to be counted (as with any active infection).

Good luck. Wear earmuffs.

- matt

[JockNYC74]

Hey bro....


Theres no changing what's been done so the best way to help yourself is be honest to your MD.  I think all of us on certain drugs (on Atripla here as well) have wanted to do what you did so don't be too hard on yourself.

Call your MD and f/u on the tests and see what she recommends, hopefully she will not be judgemental at all....

ED

[J.R.E.]

Hi,

Let your doctor know, when you stopped taking atripla. Tell her the reason you stopped, and, I also agree with Matt, see what other combinations may be available to you, that you will be able to tolerate a little better.


Good luck----Ray