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Switching from Norvir/truvada/Prezista combo to Atripla
Feb 18, 2011

Dear Dr.

I am healthy HIV 40 years old male with undetectable viral load and healthy CD4 count and %. Started meds about 2 years ago when my CD4 went down to 582 and my dr put me on a combo or Norvir, prezista and truvada once a day. I reacted well to medications, immediately my VC was undetectable and I had no side effects what so ever. Last week my dr suggested switching to AtriplA mainly for the reason that it is one pill a day and it's easier to manage than the combo that I am currently taking. I tried the AtriplA on Monday night and it was a night from hell... the vivid dreams were more like full blown hallucinations and I was really dizzy and foggy all day... so I stopped taking it and went back to my old combo (I am having to complete my dissertation at the moment and cannot big so foggy and dizzy) what is your advise on the matter? my questions are: Q1: is norvir/prezista/truvada just as good combo as AtriplA? Q2: on the long run, which is best? Q3: which of the two alternatives is safest when it comes to body fat changes? Q4: can I drink alcoholic beverages at night when I am taking AtriplA?

many thanks for your help and advise

kind regards

Response from Dr. Henry

ALthough not compared in a large published clinical trial, my impression has been that boosted Prezista/Truvada compares well overall to Atripla. The former has more problems with mild stomach complaints, the latter more problems with central nervous system complaints (that usually diminish over first 2-4 weeks). No long term comparative pusblished data (ie > 2-5 years) exists for those two regimens. My experience suggest that the two regimens seem similar as far as risk for body fat problems (comparatively low risk for significant fat loss). You can drink alcohol with either regimen though some patients may experience lowered tolerance. Recommend averaging < 1-2 drinks/day for overall health impact. KH



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