I have a two-part questions:

I began Atripla about two weeks ago. After seven days I broke out in a skin rash. I have been told this is from Sustiva.

The rash began to subside after five days and then came back twice as bad and spread to my face as well.

I do not want to discontinue using Sustiva and start a protease and booster since Sustiva is such a powerful drug with limited side effects. Can I expect this rash to go away? After how long should I give up and get off Sustiva?

Second question:

Do you question the efficacy of Atripla versus the standard regime in it's multiple pill form?

Generally one can treat through the Sustiva rash with antihistamince, acetominophen, fluids and several weeks of time. If the rash intensifies with other symptoms (fever, shortness of breath, eye/mouth involvement) then strong consideration needs to be given to stopping the Sustiva and switching to an alternative drug. My own preference is to not start with combinations like Atripla but rather be able to work with the individual components of regimens until it is clear that all of the drugs are reasonably well tolerated (for example in your case if the Sustiva is not tolerated the Atripla has to be stopped and the other drugs in the combination are in a sense wasted). KH