I have been on atripla (origially truvada and sustiva) for over 4 years after diagnosis of aids (101 t-cell vl 64057). For the last three months I have been having muscle pains and weakness in both upper arms, and now my lower right leg - front and back. I have also been getting veriy fatigued - needing a nap at lunch time if I can get home. They sent me for blood tests (muscle cpk, testosterone (for fatigue) and thyroid function.) For the second time only in four plus years I forgot to take my meds the night before going for the blood tests - found them last night on the night stand. I did notice that most all of the muscle pains left, and now that I took the atripla last night the pains and weakness are back - and much more noticeable I might add. I never realized that the pain was so potent until it was mostly gone for a day - I felt GREAT yesterday! My Dr's partner gave me celebrex samples to take for the pain, however I can't use that drug due to a sulfa drug allergy (Bactrum gave me Steven Johnson Syndrome shortly after the HAART was started) Please advise me if this could be the start of lactic acidosis and what I need to do now - not only for meds but the pain.

Atripla very rarely causes lactic acidosis which if present generally shows up on properly obtained blood tests. It is noteworthy that the pain seemed to improved when a dose missed. A trial on an HIV alternative regimen for a month or so (such as a boosted PI or raltegravir based regimen) might be worth considering if the pain you are experiencing cannot be explained by any other conditions. KH