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Resistancy to Atripla
Jul 2, 2008

Resently I attended a Pharma confrence by the company that produces Atripla. The doctor they had giving a short seminar said that there is established proof that you cant become resistant to Atipla because of the three agents. Apartently they leave the HIV cell at different times. Is this true?

Response from Dr. Sherer

It is true that the three drug combination of efavirenz, tenofovir, and emtricitabine that comprise the single once daily tablet called Atripla has an excellent record of durable viral suppression. In one long term study, the majority of patients maintained control over 5 years.

And it is true that an advantage of Atripla is that each drug as a long half life of 1-3 days in the blood, and that each drug has a different mechanism of action that, when combined, slow or stop viral replication. The benefit of combined antiviral activity is actually true of ALL 3 drug ART combinations, though not all 3 drug combinations have long half lives in the blood.

However, it is definitely NOT true that "you can't become resistant to Atripla" for any reason. A responsible HIV physician would not make that statement, and I doubt that your interpretation of their statement is accurate. Two of the three drugs - efavirenz and emtricitabine - in Atripla are quite susceptible to resistance, which can develop in a matter of hour or days if there is inadequate adherence, low drug levels, or other factors that interfere with the normal action of the 3 drugs.

I suggest that you talk to your doctor about drug resistance and your concerns. It is important that you are clear that resistance is a major potential threat to the health of a person living with HIV, and that there are ways in which you can reduce the threat to the lowest level possible, mainly by always taking your medications as prescribed.

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