Decrease in CD4 count after using VIRADAY tablets

Question

My friend is 58 year old and he is on Tablet VIRADAY from October 2008,His CD4 before taking tablet was 263, in May 2009 it was incresed to 540 but now in October 2009 his CD4 again reduced to 243.He has become very weak.. wt should be the next step to save him

Answer

Hello,

Assuming your buddy is adherent with his medication regimen and does not have an intercurrent opportunistic illness that might be driving his CD4 counts down, I would be concerned that he has developed resistance to one or more of the drugs in his Viraday(generic Atripla). I would recommend he be evaluated by his HIV specialist physician and get HIV resistance testing (genotype/phenotype). This will determine if resistance has developed and be of assistance in selecting a new combination regimen for him.

Dr. Bob