hello. i'm 25 y.o. diagnosed with both hiv & hep b. i have not had to take any meds for the last 3 years, until my hep b viral load started to rise, as well as my liver functions. my doctors want me to being treating both as treating the hep b alone may cause resistance in the hiv. my question to you is, would you recommend atripla to truvada or vice versa and why? also being 25, how likely is it that i will develop toxicity in my liver after time from taking the meds? thanks

Excellent question. We are fortunate now to have great medications that treat HIV and HBV simultaneously. These medications include emtricitabine, lamivudine, and tenofovir. Atripla is a single pill that combines two of these HBV/HIV medications along with efavirenz, a drug that has only HIV activity. Truvada combines two HBV/HIV medications into one pill and must be taken along with another HIV drug of your doctors choice to treat HIV as well.

So in other words, from a HBV standpoint, there is no difference between Atripla and Truvada, which include two HBV-active drugs. Atripla just has an additional HIV medication included in the one pill.

Your physician will want to monitor your liver function tests while you take the medications, particularly in the first few months while your body is getting used to the medication. Sometimes there can be a "flare" of liver function tests, but in the long run it is important to treat your HBV infection if you have liver disease.