Hello Dr. Young. I submitted a question to you a few months ago right after I tested positive and I want to thank you for your help. I have since started on truvada/sustiva with very little side effects. I have had a slight sexual side effect, difficulty achieving orgasm. I haven't seen that in any literature, is it common and do you think it will dissipate over time? Also, about a week into treatment, I developed a severe rash which went away a few days later. Are there other side effects that appear later in treatment I should be aware of. Thanks again so much just for being here. Your answers always give me hope. JB

JB-

Thanks for your help and comments. It makes me feel good that my commentary has been of value to your spirit.

I'm also happy to hear about your medications and overall tolerability.

Sorry, but I'm not aware of any sexual side effects of the regimen, though I'd mention it to your doctor to make sure there isn't any other medical reason for your difficulty.

In general, the regimen of tenofovir/FTC (Truvdad) + efavirenz (Sustiva, Estocrin) has very little issue with long-term toxicity or side effects. Tenofovir patients (like all HIV patients) should have their kidney function ("glomerular filtration rate") monitored; some patients on efavirenz can develop mood issues (though cause and effect has been debated).

Hope this helps, stay in touch and report back on your labs and symptoms. Many of our readers would be interested in hearing.

Best of health, BY