Question
I'm worried about my partner drinking heavily on Atripla
8 August 2011. Related: Adherence, All topics, Drug interactions, Support.
My ex has been taking Atripla for years now and has recently started drinking heavily. Should I be concerned? What are warning signs of this causing problems?
Answer
The main concerns with alcohol and HIV meds it the risk of missing or being late with medication. If this becomes routine, then the person risks developing resistance.
Resistance can develop very easily with Atripla if the person misses several doses in a row os each week. This is because two of the drugs in Atripla – efavirenz and 3TC – have very low thresholds for resistance.
If his viral load is undetectable (less than 50 copies/mL) then occasionally missing a dose, while not ideal, will not develop resistance.
So technically, so long as your partner doesn’t miss meds then his treatment will be ok. The trouble with heavy drinking though is that however concerned you are when sober, when you are drunk, meds, and a lot else besides, doesn’t really matter.
There have been several studies that reports alcohol use with adherence and alcohol use with treatment failure (due to adherence). So a warning sign here would be doses that are not being taken each day if he uses a pill box, or extra doses left in the bottle a month after they were prescribed.
If your partner has mood changes associated as a side effect of Atripla, then the effect on alcohol on his mood could also increase this effect.
Alcohol can be one of the most destructive drugs. I don’t know anything about you and your ex or your history together, but if this is becoming difficult for you, you would get more direct help about other alcohol related services and problems form a local drug and/or alcohol support group.
You are clearly worried, but your ex has to see this for himself in order to get help.
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