Q and A

Question

Can I return to my first ARVs – I have side effects with second-line?

Hello can i change from second line back to first line cz the second line is giving me too much problems with side effects.

Answer

Thanks for getting in touch.

For me to be able to answer I need to know why you changed the first treatment?

If this was because your viral load had either increased or not become undetectable, then the first treatment was not working well enough.

This means going back to the first treatment would not be good.

If you changed for other reasons, and your viral load was undetectable when you changed, then you can use the first treatment again.

What treatment were you taking and what are you now taking now?

It would also help to know your CD4 and viral load? Also, which country do you live in?

38 comments

  1. Josh Peasegood

    Hi Mark, what is the second line treatment you have been taking? and as you are undetectable is there a reason you want to switch?

  2. Mark

    I have been on second line treatment and now undetectable. Can I take Atripla now( one tablet a day)

  3. Josh Peasegood

    Hi Julia, it is good to hear your mood has improved since July. Is there a problem with the current treatment you are taking for HIV?

    As you had switched to avoid drug interactions, it would be okay to switch back as there is no risk of resistance to treatment. How is your viral load?

  4. Julia

    Can i go back to the first line if i was taking the second line because of taking depression medication. As the doctor said taking first line with depression meds will cause my mood to be more down. Now i’m finished with depression treatment since last year July but still taking the second line.

  5. Josh Peasegood

    Hi Gillian, unfortunately you cannot go back onto treatment that has previously failed. As your viral load was high, it means that HIV was resistant to that first line. Even though you are both now undetectable, you will both still have HIV that is resistant and going back risks HIV no longer being suppressed.

    What 2nd line combination are you now on? There are a number of drug combinations and depending on where you are, there may be other options available for you to try. Also, have you mentioned these symptoms to you doctor? There may be other ways of managing these other than changing medication.

  6. Gillian

    I was on first line for five years I was doing fine with no side effects my body looked health unfortunately my viral load was high this was because my husband was not taking meds.The doctor changed me to second line of which am undetectable today and my husband, now the problem is am having a living hell alot of sicknesses, my body can not look health anyone, please can I get back to the first line because both of us are undetectable

  7. Josh Peasegood

    Hi Ricky, your CD4 count and viral load is great. What was your 1st and 2nd line drugs? If you were not changed from your 1st line combination because of resistance, switching back for a few months should not be a problem. Congratulations on your pregnancy. Neither drug will risk the health of your baby, in fact it is healthier to remain on medication for baby’s health.

  8. Ricky

    I have been on antiretroviral drugs for 18 years now. I was on line 1 for 5 years when my doctors ( it was a decision made by more than a doctor) decided I change it to line 2. The line 2 drugs has been wonderful. I hardly fall sick.
    I went for my drugs today and was told the line 2 drugs are not available I have to make do with line 1 drugs for 3 months after which I will run a viral load test. I am pregnant right now, is it safe to change my drug? (My current cd4 is 751 and viral load is undetectable)

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