Effectiveness of Atripla
Apr 18, 2013
Been on Atripla near five years with average of CD4: 500 (26%) and undetectable since starting. In last year, the CD4 numbers have steadily declined to 400 and viral load increased to detectable while CD4 percentage remains stable. Dosage adherence positive with no side effects. Is it time to discuss alternatives? After this long time positive response is the slow changes expected?
Response from Dr. Henry
CD4 counts can sometimes trend up and down even if the HIV regimen is effective. If the HIV level is consistently detectable (>>50 copies/mml) that is a concern particularly if increasing to > 200-500 (often in that range a resistance test can be run to determine if your virus has mutated and developed resistance to one or more of the components of Atripla). Levels > 200-500 on a consistent basis while on Atripla in setting of good adherence often warrant a change to an alternative regimen (is a boosted protease inibitor based regimen due to concern about drug resistance). KH
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