Switching from Atripila to Triumeq

Question

I've talked to my doctor about Atripila to Triumeq. The. possible benefits being no more vivid dreams (which often rob my husband of sleep) and long term bone concerns that come from taking Atripila.

I am indictable and have been for over a year with a normal/high CD4 count. I do not want to trade one batch of mild side-effects and end up with others I can't foresee yet.

Is the switch beneficial? Are here any potential long term benefits besides the two I mentioned? I have been tested and am not hypersensitive (allergic) so it's a option.

Answer

Hello and thanks for posting.

First off, if you're not having any side effects from your Atripla (really), and not having any toxicity (bone, kidney or mood), then there's no rush (or perhaps need) to switch medications.

But you mention mild side effects.... and then the potential for bone health problems.

Triumeq was shown to be superior to Atripla in a very large randomized clinical trial called SINGLE- indeed, it was this study that in part, led the US government panel to no longer recommend Atripla for first line treatment of HIV. Why was this? Triumeq was overall better tolerated, with fewer people having treatment discontinuations for side effects, and among those who did not stop therapy, in general, fewer side effects as well. Since Triumeq does not have the tenofovir (TDF) medication, it's risk of kidney and bone complications is negligible; and there's none of the psychological side effects of Atripla's efavirenz component.

You've been appropriately genetically screened for risk of abacavir (part of Triumeq) and was negative, so you're in the clear.

Overall, I tend to discuss risks and benefits of switching, but if you're having side effects from Atripla, it's pretty clear that Triumeq will likely result in net benefit, with few risks.

Hope that helps, and do write back and let us know how things work out. BY