I have been positive/asymptomatic for 21 years and have been on Atripla since 2007. Priro to that I was on Crixivan/Epivir/Xerit since 1997, with successful results (un detectable and high tcell count). There were no significnat side effects until last years when my sleep cycle began to suffer. I have had to take Melatonin supplements almost daily with 60% success and am tired of having to depend on it, sleepless nights, feeling hungover if I do sleep, and drinking coffee just to stay awake during the day. Is it safe to switch to Complera now?

Thanks for your question.

There have been a couple of studies looking at switching from stable regimens to Complera. In one, patients who had been on Atripla with undetectable viral loads for at least 3 months (as in your case) successfully switched to Complera and maintained viral suppression.(http://hivinsite.ucsf.edu/insite?page=hmq-1201-02).

Switches made before the virus is suppressed may be more risky due to a drug interaction between efavrienz (part of Atripla) and rilpirine (part of Complera). This is less of an issue once the virus is suppressed (3 months is a reasonable time) because the blood levels of the Complera will stabilize and maintain control of the virus.

Remember, unlike Atripla which should be taken on an empty stomach, Complera needs to be taken with food (400-500 cal meal) and you should avoid antacids and other stomach acid blocking medications while taking it.

Best, Joe