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Mar 27, 2013

I am currently on Atripla with a 908 CD4 count /VL <20. My employer indicated that they may do random drug testing where we will have to go to a lab and give a urine or blood sample. What do I tell the lab when I give them the sample so a false dope reading does not surface? Do I just say do a confirmatory test? Perhaps switching to Complera or Stribild would be an option to avoid controversy? I would not want to pursue that alternative because of how successful Atripla has been for me. Your advice would be most appreciated. I was diagnosed in 8/99 with a baseline VL of 36,000 and a CD4 count of 370. I was on Combivir and Ziagen for 10 years before switching to Atripla in 9/09. I never had a detectable VL or fell below 500 T cells once I started treatment in October of 1999.

Response from Dr. Young

Hi and thanks for posting.

It's the efavirenz in Atripla that used to be associated with false positive drug tests. This has been resolved in modern tests, as I understand.

Since neither Complera or Stribild contain efavirenz, there's no risk of this false positive test with these combos.

I wouldn't use this issue as a reason to switch medications, though there might be a host of other reasons, perhaps related to the tolerability or side effects of the efavirenz.

I hope that's helpful, BY

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