Choosing Treatment

[pursuit]

Hi all,

I was tested positive 2 months ago. In the following weeks, I found out that my CD4 was 373 (22%) and VL 17000. This week, after 3 weeks of waiting, WB test confirmed + and today I checked my CD4 again and came back at 299 (waited just an hour to get the result – is this normal?).

I saw a doctor (at the time when I only know my CD4 is 373) and she recommended me to start treatment immediately. She didn’t ask me to do VL test as she reckoned it is too expensive. There is only one place offering WB in the country where I live and so far I haven’t find a place that offer genotype test. So VL and WB tests I did were my own initiative. She did, however, test me on standard hematology, liver and kidney functions and the results are all normal.

The option for first line treatment here is the choice 3TC/AZT or FTC/Tenofovir, and the choice of Efavirez or Nevirapine, all generics. As they are all fully subsidized by government, the availability is another issue – sometimes they are run out of stock and need to switch patient with anything they have in hand at that time. I think I would choose FTC/Tenofovir and Efavirenz combo, as I believe they are the preferred first line treatment both in the US and UK (am I right?), not to mention their once-a-day only commitment. I hope when time (hard to get leave from work) and finance permit, I would be able to fly out to Bangkok and bought a 6 months supply of Atripla like what many have said in this forum. 

My questions are is it ok if I take the FTC/Tenofovir and Efavirenz combo now and suddenly switch to generic Atripla and then switch back to FTC/Tenofovir and Efavirenz at any time? I remember someone here talking about the importance of having a back up, that’s why this idea comes to my mind. Also would it be worth for me taking genotype test later in Bangkok after I start taking my treatment?

Reading people’s experience and knowledge shared in this forum helps me tremendously in understanding the virus. Seems like I rely more on the information gathered from this forum, rather than my doctor, but I just want to make sure I do everything right from the beginning. My doctor is ok, my counselor who recommended her to me think she is the most caring doctor in my city, I’m just not satisfied with the fact that she always tried to get me out of the door before even 10 minutes of consultation. May be this is just the way things work here in my country.

Thanks for reading my post.

[mecch]

My questions are is it ok if I take the FTC/Tenofovir and Efavirenz combo now and suddenly switch to generic Atripla and then switch back to FTC/Tenofovir and Efavirenz at any time?

that is not a switch.  FTC/Tenofovir + Efavirenz =  Atripla (generic or name brand)

Thats the only question I know the answer too.  You asked a number of questions and I am sure other people will answer them.

Note that if you have a history of anxiety or depression, Efavirenz is not the preferable molecule, but if you have limited choices, one makes do with what is available.

Welcome to the forum.