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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest an alternate medicine for Atripla

Answered by
Dr.
Dr. Sunil Jangid

HIV AIDS Specialist

Practicing since :2009

Answered : 1955 Questions

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Posted on Sat, 3 Sep 2016 in HIV and AIDS
Question: Can I say Atripla is not working? my sister is on Atripla and after 15 months of use her viral load is 184 and her CD4 is increasing gradually from 45 to 150 and the last test is 134 shall I see medication change?
doctor
Answered by Dr. Sunil Jangid 36 minutes later
Brief Answer:
No need to change medication.

Detailed Answer:
Dear Sikij,

Welcome to HCM.

If CD4 count is increasing then Atripla is working in proper way as per its effect. Every drug need some time to show its effect fully so don't get feared and no need to change the medication at present.

Thank You
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sunil Jangid 31 minutes later
Thank you doctor,
Most doctors told me don't look up CD4 count once we start Atripla but VL but viral load even in 15 months still cannot be under 50 and even if we look CD4 count also it is not a significant increase. I fear the advantage getting from this damn drug is not comparable to the side effect. If it is this much slow in the mean time it definitely affect our organ.
doctor
Answered by Dr. Sunil Jangid 6 minutes later
Brief Answer:
Nothing like that.

Detailed Answer:
Dear Sikij,

Welcome back and thanks for follow-up.

I understand your condition but we have to wait for at-least two years because we can suspect failure of drug only when three consecutive CD4 count is below 100 or it falls below baseline level.

If the drug is having any effect on organs then the symptoms related to that will develop and you will come to know but I don't think right now you have any such problem so no need to worry so much.

Thank You
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sunil Jangid 28 minutes later
Thank you dr for your reply
My sister's husband also HIV+ and his baseline test was 342 and VL 1785 and after 8 months his CD4 is 332 and VL 3,600 completely healthy no ARV at all. What is your comment doctor?
doctor
Answered by Dr. Sunil Jangid 6 minutes later
Brief Answer:
No need of starting ARV.

Detailed Answer:
Dear Sikij,

Welcome back once again.

CD4 count is corner stone in taking the decision of starting ARV. If CD4 count is more than 350 and no symptoms are there then no need to start any ART medicine that is why he is healthy without ARV.

Thank You
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sunil Jangid 5 minutes later
His CD4 count is not 350 it is 332
doctor
Answered by Dr. Sunil Jangid 8 minutes later
Brief Answer:
Yes but it is 350 as per guidelines.

Detailed Answer:
Dear Sikij,

It is 350 as per routine HIV guideline but it depends on the physician if patient has no symptoms at the time then he or she can delay the start of ARV with regular monitoring of CD4 count. If CD4 count falls below 250 then we have to start ARV regimen.

Thank You
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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