I am living in Yangon, Myanmar (Burma) and was diagnosed + in 2/2007 and put on a regimen which is much like your Atripla but 3 separate pill. Now I cannot receive one of the drugs because of currency restruiction of government, I cannot get this drug through outside source. My Doktor has 15 bottles of American Atripla (30 pills each bottle). Bottles have been never opened, but problem is that they all expire 11/09. He says I should take anyway, that the drugs will still work, otherwise I can only have two of the drugs I had, and that would be dangerous. My Question put to you: I know you cannot advise persons to take expired drugs in normal situation, but because of fact that this is all I can get, is expired American Atripla better than just two drug combination? I am not too concern about december -march, but afterwards april onwards. I cannot pay for good drugs on illegal market. My viral load has been not detectable since treatment begins. thank you very much. Friend who is pharmacy officer in army (he cannot these type of HIV drugs) says to me expiration date not too important ... drug usually good for at least year after expiration if stored as directions say. Myanmar is isolated country. People w/ HIV are treated as suspect group, given no help from government.

I am sorry you are in such a dilemma.

You have a choice between 2 less than desireable courses. There is no doubt that taking only 2 medicines will lead to treatment failure and likley resistance of the virus which could limit future options for treatment. So that is clearly a poor choice.

It is true that the reliability of expired medicines may be questionable, but your doctor is right that it will not suddenly become ineffective on November 30, 2009. If your CD4 count is low and you have no access to that 3rd medicine, this looks like the better option. Perhaps in the next several months you may be able to get access to the missing 3rd drug and get back on your old combo.

I wish you the best.

Joe