Question
CD4 70, on Bactrim and Atripla, are there any interactions?
5 April 2012. Related: All topics, Starting treatment.
Hi. I recently got diagnosed with HIV. CD4 count of 70 and Viral count over 400,000. Pretty bad.
My doctor has started me immediately on Atripla and I feel a bit better after 2 weeks. In addition he has put me on Bactrim to prevent any lung infection due to the low CD4 count.
The question I have is do the two drugs I am taking have interactions that I should be aware of? Also has anyone gone through the same meds together? Thanks.
Answer
I’m sorry to hear about your recent diagnosis but it’s great to hear that you’re starting to feel better already.
Because this answer is being posted online I’ll explain first of all the different drugs you are using.
Atripla contains three HIV drugs- efavirenz, FTC, tenofovir. This is a recommended first line treatment in both the USA and UK. More information about Atripla is at this link. This includes information about how to take it, and potential side effects.
Bactrim is the trade name for co-trimoxazole, which is made up of two drugs trimethoprim (TMP) and sulphamethoxazole. This is a standard treatment given to people diagnosed with a CD4 under 200 to reduce the possibility of developing a pneumonia called PCP. This link has more information on PCP.
You should feel very confident in this treatment. It’s the first option that would be given to somebody starting with a CD4 under 200. These drugs should not have any interactions with each other. If you do experience any side effects or new symptoms you can talk to your doctor about these.
I wish you the best of luck with your treatment, please do get in touch if you have any further questions.
If you’d like to read more about HIV treatment please take a look at this Introduction to combination therapy.
Hi Phiki,
It’s normal to be nervous when starting treatment. Knowing what to expect can make starting treatment much easier. Tribuss is a generic version of a combination drug called Atripla. You can read about Atripla at this link.
I’m about to start with Tribuss and I’m nervous please advice my CD4 count is over 460.
Thank you
Please follow this link to a similar question.
Is there a problem if one takes Atripla in the morning?
If you are allergic to purbac you will also be allergic to Bactrim. These medicines contain the same active ingredients. It’s important to talk to your doctor or pharmacist about this. There are alternative medicines available for people with this allergy.
I have been on treatment for about 2 years now and i have been using purbac, efervirenz, truvada and nevarapine. I got allergic to purbac and nevarapin within the first three months of medication. I was admitted to hospital due to overreaction, my doctor changed my medication to truvada and efervirenz only and i only took medication at night.
Then he changed again to Atripla which i have been using for about 7 monhts now.
I had a problem of pains and the other Doctor diagnosed me of mitral valve prolapse, which he said was not so much dangerous and as my cd4 count took long to increase, he prescried for me Bactrim ll and when i got to the chemist they gave me the generic which is purbac.
I was not aware that it was the same pills that i got allergic to but only realised when i got home as i realised that i recognise the name of the tablets.
I then looked at the first list of medication that was changed for me and found that purbac was indeed there.
If I go to the chemist and explain this, will the Bactrim ll not give me problems since it is a genereic to purbac if they change purbac with it?
Hi Nomathemba,
You mention your wife’s CD4 count, and also your own. This is a little muddled up though, and I’m not sure if the test results you give me refer to one person or to two?
CD4 counts fluctuate- they go up and down. The different numbers you have given don’t show big clinical differences, and these wouldn’t necessarily be seen as a drop in CD4. To know whether these should have increased I would need to know how long you have been on treatment, and what you CD4 was when you started. If you know your viral load results this is also useful. Please send me this information and I will try to answer any questions.
my wife started with a cd4 count of 46 and she was put on ARV’s atripla and TB treatment together with purbac double strength.After completion of TB tretment I found that the cd4 count has gone down to 33.My doctor then changed me to tribuss tablets and proceeded with purbac double strength and after my recent blood tests my cd4 counts has dropped to 20. Please help
Hi Rocky,
Atripla contains a drug called efavirenz. Efavirenz can cause dizzyness and sleep disturbance. For most people this gets easier to tolerate after a few weeks. About 20% of people taking efavirenz do change within the first year because of side effects. It’s a good idea to take some time off work until these side effects get better. And if you keep having problems talk to your doctor about them. For more information please take a look at this guide to efavirenz side effects.
first night first dose of atripla. wow, very interesting does this get easier and with the dizziness is not a good idea to work ( comercial roofer of 35 years)