Advertisement
Response from Dr. Sherer

This is an unfortunate and very uncommon set of events with the combination of drugs - efavirenz, tenofovir, and emtricitabine - that are in atripla, but it is known to occur. Around 3-5% of people on efavirenz will get a rash that is usually mild and self-limited, and a much smaller percent will have more severe rash, as you did, that require stopping the medication and trying an alternative regimen.
While I understand your concern, there is no reason to be alarmed about your next regimen, for at least three good reasons. First, there is no emergency for you to start ART, and you and your doctor can safely take the necessary time to get it right, i.e. to start you on a regimen that is effective and that you tolerate well.
Secondly, there is not an increased risk that you will have another adverse reaction to a different regimen, as you did to this one.
And thirdly, there are several good alternative regimens that have a high success rate for controlling your viral infection and increasing your CD4 cell count. These include regimens that like atripla can be taken once daily. These choices will involve more than a single pill once daily, but otherwise have good potency, tolerability, and durability. You could ask your doctor about once daily protease inhibitors such as lopinavir (Kaletra) or atazanavir (Reyataz).
I urge you to talk to your doctor about your concerns and these suggestions.
Want to read more questions and answers on this subject? Our experts have answered many similar questions!
|