Mar 31, 2012
Hello, I am moving to Japan permanently for work. I was diagnosed 1 month ago. My CD4 is 245 and VL 167000. My doctor here wants me to start Atripla, and then go see a new doctor in Japan, but that could take me a few months. I can take the Atripla with me, a 3 months supply. I don't know if they have Atripla in Japan, and they might need to change my treatment there. Should I wait 3 more months and see a Japanese doctor before starting any treatment or start Atripla now? Thank you so much.
Response from Dr. Young
Hello and thanks for posting.
First, with your current lowish CD4 and high viral load, I wouldn't recommend waiting too long to start medications. Indeed, with a three month lead time, one could be certain that your going to have sufficient time to monitor your side effect and lab response to treatment. While this isn't your question, it would be worthwhile making sure that this is your best treatment option- for example, do you have normal kidney function and don't have history of fragility fracture. Does your job require frequently night shifts?
There are excellent HIV care facilities in Japan- I just returned from working with the doctors in Tokyo. As I understand, the medications in Atripla are available in Japan. Worse case, should you have tolerability issues, the same set of alternative medications are generally available there.
Be well, BY
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