Question
Should I be so optimistic now I have started treatment?
12 July 2008. Related: Adherence, All topics, Side effects, Starting treatment.
I am a healthy male, 40 yrs old, HIV-positive for 18 months now.
I’ve been on meds for 8 months, yes, started sooner than expected. My viral load was 400,000 and my CD4 was 180 when I started meds, and it is now undetectable with CD4 count of 490 cells/mm3.
I am on Atripla (efavirenz+tenofovir+FTC) and would like to ask if it is wrong to feel so optimistic about my future? I only experience side effects if I eat a sugary meal too late at night. Dreams become a bit dizzy, so I avoid this kind of food after 9pm.
Should I take my meds every night or can I miss an odd one? Can this regimine last for many years?
I feel mentally HIV-negative again, though would never have unprotected sex again. I don’t want anyone giving me anything else! To people who are afraid of the meds I would say “don’t be” – as I said mentally more than anything they have saved my life.
Answer
Yes. You should be so optimistic, as apparently the therapy works perfectly OK for you. This means that if you take it appropriately, without missing doses, then it is expected to work for you for many years to come. That really is great news.
If you find adherence difficult and miss doses this may lead to resistance and you would have to change your therapy. You should tell your clinic about this and they may be able to help with other ways of support. A new combination may be less agreeable with you, so, perhaps it does not worth blowing your chances – take adherence seriously!
The advice about food relates to a high fat meal, rather than one that is high in sugar (though some food is high in both). A high fat meal increases drug levels of efavirenz, which will make those side effects (dizzyness, dreaming) more likely.
Otherwise, yes, make your plans and live your life. Great news!
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