dear dr,

I started Atripla 3 months ago after CD4 went bellow 350 (280-290). After first month of feeling deezy and groggy in the mornings those side effects have subsided. However lately I'm starting to feel very fatigued. I do ok during the day but come evening I just crash in front the tv even at 7-8pm. I also am having problems sleeping a good night sleep, waking up at 5-6am and unable to sleep in late even if I have my whole day free. Even sleeping pills I take on occasion (Ambien CR) don't help that much. [First month on Atripla I slept better coz the meds just knocked me out, but now that I got used to them I suspect they might interfere with my sleep]. Should I switch to morning dosage rather than bed time?

Also, yesterday I had a routine general physical exam by a doctor who's not an HIV specialist, and he mentioned my eyes seemed a little yellow (I see some redness but nothing yellow..). I know that can be a common side effect for Reyataz but not for Atripla.. Could that, plus the fact I'm so fatigued, point out toward some coinfection going on?? I'm not scheduled for lab tests for another month and a half.. Should I insist on seeing my doctor earlier?

Thank you very much!

Did your other doctor run any blood tests, like liver enzymes or test for hepatitis viruses? Yes, your symptoms could suggest a co-infection with HCV or HBV.