I am recently diagnosed (Jan.'05) and have a cd4 count around 350 and a falling vl of about 40,000. My doctor has prescribed Sustiva (along with Truveda) and I am aware of its brain-related side effects. My big fear is that I will lose my mental accumen, which is necessary in my job. I have to be sharp during the day to accomodate the rigors of my position. Are the side effects of Sustiva only active in the sleeping hours after a bedtime dose, or will the effects dull my mental reflexes throughout the following day?

Thanks for your post.

Your concerns are not uncommon ones; efavirenz can cause some psychological side effects. For the vast majority of persons, including many of my own patients, these side effects diminish in a matter of days and are not noticed the morning after the dose. I wouldn't use your apprehension about the rare potential for persistent side effects as a reason not to take a generally very well tolerated and very potent regimen-- should you have unacceptable side effects, you and your doctor can find an alternate.

Good luck, BY