Hi I was tested positive for HIv with Viral load count of 6271 and CD4 of 175 45 days back. I was put on Viraday one pill a day. It is 45 days since I am taking it. But am having impaired concentration. I can't concentrate properly and get into frequent depression. Its with a heavy heart I take the pill everyday. After 25 days my viral load was <50 and CD4-134. Is there an alternative. Can I take it on alternate days. I am also trying out some herbals promised on the net to oust HIV. I am 48 years old. The experience is totally destroying me. If I stop all medication how long will I surivive.

Viraday, Cipla of India's generic Atripla contans the most widely recommended first line drugs. The side effects of the efavirenz are not to everyone's liking. While they typically settle in the first few weeks it sounds like yours are both persistent and disagreable. The aim would be to try and stay on the other drugs (tenofovir and emtricitabine) and swap the the efavirenz to nevirapine, the alternative NNRTI likely to be readily available in your locale. Your sleep, concentration and mood would likely improve somewhat over a few days and entirely over a few weeks if all efavirenz related. You should talk to your doctor about accessing the alternative medications. Stopping is not a realistic option, it would risk resistance especially to the NNRTI drugs and with you numbers you would be expected to get sick durng the next year and have a high risk of death in the next few years. If you want charts on risk see the BHIVA guidelines at www.bhiva.org which include actuarial charts based on the ART collaborations work I am sure your doctors will help you stick with it! Best regards Dr Moyle