First combo. Viramune and truvada for 3 months and I never have energy. I lead a healthy life and a 28 year old male. Everything thing else checked out okay and I can tell the fatigue is from the meds. T cells went from 321 473 in a month. CD4 % went from 23 to 33% and VL went 32,000 to 320. All the other side effects went away but I'm having problems dealing with this. Friends tell me to stick it out but it's gotten in the way of school and I'm having problems keeping a job. I was thinking into trying reyataz and norvir. Nobody I know has such a reaction to Viramune. My doc thinks it's odd. What gives? Should I be more prudent with regimen switches?

It is still relatively early in your treatment. Many other causes for fatigue including anemia, hypothyroidism, poor sleep, depression, liver problems need to be considered before settling on a direct effect of one of your HIV drugs as the most likely cause. If one drug seems implicated than a carefully considered switch to an alternative drug on a trial basis (as you outline) often is very reasonable to consider. KH