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Switching from Sustiva + Truvada to Viramune + Truvada
Apr 6, 2006

Hello and thank you so much for contributing your time, knowledge and experience to so many people.

I have been taking Sustiva and Truvada for about a year now and have always had difficulty staying asleep with this regimen. In addition, I feel like I'm not quite myself since taking this combination. My mind is somewhat cloudy, I'm less confident and kind of agitated at times. I work in the computer field and there are occasions when I have to respond to some issue in the middle of the night - which terrifies me because a few times I've had to go into the office in the middle of the night and I've been in a complete mental fog - barley able to produce a cohesive thought.

I was hoping the effects would wear off over time, but after a year there does not appear to be an end in sight.

I am considering a switch to Viramune and Truvada but am worried about Viramune possibly being more risky in terms of developing resistance than Sustiva.

Can you please provide any insight or opinions you may have regarding this? I would love to get off of ther Sustiva and get my brain feeling back to normal, but I certainly don't want to risk a greater chance of resistance.

Thanks very much for your help.

Response from Dr. Henry

The barrier to resistance for Viramune is fairly similar to that for Sustiva so I would not worry alot about the particular aspect of the switch. Viramune has less central nervous system (including sleep) disturbance related side effects than Sustiva so that is a plus. It has a different profile for side effects (rash, liver, hypersensitivity type reactions) so a switch needs to be be carefully monitored but generally goes OK. A boosted protease inhibitor is another option for switching. KH

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