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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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High Triglycerides and Lack of Sleep
Feb 6, 2001

The first of November 2000 I received positive results for HIV. I sought more help immediately. My levels were: CD4 304 and Viral Load 224,000. I began the easiest combination treatment at the end of Nov. of Combivir and Sustiva, since the virus was sensitive to all current medications. As of Jan 10 my viral load is now only 712 and CD4 is up to 314. I have had trouble with long term sleep at night. I get 3 or 4 hours and then I can't go back to sleep. My triglycerides have risen significantly (110 to 900) in the six weeks (bad genetics on both sides of the family). I understand psychosomatic effects of the disease, but I still feel that part is due to the medication and possibly elevated triglycerides. My HIV doctor says she will not address the triglycerides--that is for my primary care doctor--and the lack of sleep could be not related to any of the medication.

Response from Dr. Young

I feel quite strongly that impaired sleep can be a side effect of efavirenz (Sustiva). This tends to get better with time (even months out), or with medications to assist with sleep, such as Ambien or Sonata. Some find that Benadryl at bedtime helps too. If persistent and troublesome, your doctor could consider a switch to one of the other non-nukes, such as nevirapine or delavirdine. BY


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