As someone who has been on Atripla for over 4 years now I was most concerned after reading the study that says that effavirenz is toxic to neurons in the brain. I have been lucky with no side effects as far as fogginess, anxiety, vivid dreams, high cholesterol and triglycerides. In fact I have been undetectable for the entire time, CD4 1275, cholesterol 164, triglycerides 64. Is lack of side effects on indicator that I may not be as suceptable to the neuron damagr? Should I consider changing my medication? It was suggested that the drug can be reformulated to prevent toxicity. Is this in the works? This is is ver disconcerting in that Atripla has been viewed by many to be the "gold standard" in treatment. Your thoughts

Good question. That study was interesting but clinical relevance unclear. Long term studies of patients on efavirenz generally not picking up a clear signal of increasing brain damage. A small subset of patients on efavirenz have ongoing annoying brain side effects (often a continuation of side effects seen when first starting) that might warrant discssion of a switch to alternative treatment. More clinical data/long term studies needed to shed light on whether the study your referance translates into a true clinical effect. KH