Dear doctor,

My bf just got diagnosed with HIV positive; his CD4 count is 230 something; the local hospital has provided him meds as below: 1. Tenoforvir 300mg 2. Lamivudine 150mg 3. Effavirenz

1&2 is for morning; 2 is for night; 3 is before bedtime. My bf took the medicine, but he is feeling very uncomfortable b/c of no.3 med. He can't sleep; loses balances; vomits in the morning; has no craving. We called the doctor and she asked him to come to the hospital so that they can provide him with protein and water via the blood way (i don't know how to describe that in English). She said that he would have to go through that situation for 6-8 weeks. I just want to have your opinion if the treatment and the doctor's advice is ok. Here in Vietnam, we don't have much choice of meds or Aids clinics.

Thank you very much.

Hello and thanks for posting from Vietnam.

The regimen that your BF is taking is an excellent one and recommended in current treatment guidelines around the world.

It's not uncommon for people starting on efavirenz to experience the disorientation and insomnia that you've described; this usually fades in a mater of a few days, or within a couple of weeks. Such symptoms are also often better if the medications are taken on an empty stomach. If the symptoms persist longer than that, then it's worth discussing the severity of the side effects with his care provider.

Also, it's worth noting that his entire regimen can be taken together, once daily, before bedtime.

I hope that's helpful, and please feel free to write back anytime. BY