Question

Will I be okay without Complera (Eviplera) for a week?

15 March 2017. Related: Adherence, All topics, Resistance.

I missed 7 days of Complera, I just started back today. I switched insurance that was why it was a week unfortunately. How severe is my risk of drug resistance?

I was undetectable for 3 years and CD4 has been over 800.

I take great care of my body and health. Now I am nervous about the meds not working since I haven’t taken a pill for 7 days.

Answer

Answer: Simon Collins

Thanks for getting in touch.

Although short gaps for a few days are usually okay, a week off meds is enough for viral load to start to rebound. If you are unlucky, then drug resistance can develop while there are still low levels of HIV drugs. If you only do this once, then the risk is low, but if it happened more frequently the risk will be higher.

Two of the meds in your combination – tenofovir DF and emtricitabine (FTC) – would have continued to keep viral load load for a few days. The third drug – rilpivirine – has the higher risk of drug resistance, but the protection from the other two drugs might have helped.

However, drug resistance is easier to develop to rilpivirine than many other drugs, so your doctor needs to know about the interruption. This is why it is so important to take rilpivirine with food (so that drug levels are high enough).

As this only happened once, there is a good chance that you will be lucky. Also, as this has already happened and you have restarted, it might be good to check viral load in 2 to 4 weeks. If resistance did develop, this will find out quickly, rather than waiting for the normal 3 to 6 monthly text.

Complera is called Eviplera in the UK.