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 Dinoj,
Just to make it clear: i-Base advocates are not doctors. We can provide information about HIV treatments but this should be used to make treatment decisions together with your doctor.
The most important thing when on treatment is to have an undetectable viral load. This means that treatment is working well and that HIV is not able to multiply. So it is very good that your viral load is undetectable.
CD4 counts tend to increase quite slowly, and not everybody will see big increases- especially if you start with quite a low CD4 count. It may take several years for your CD4 count to increase to 350, and there is a chance it will never get this high. But so long as your viral load is undetectable, and you are feeling well, it’s important not to worry too much about your CD4 count.
Please see this graph for an idea of average CD4 count increases on treatment.
Hi doc, thank you for this wedsite. I am a male was diagnosed in 1994, started treatment in 2011 with atripla and bactrim when my cd4 was 135 and vl was 80 000. Been on several blood tests after treatment cd4 130 vl undetectable. My last blood test cd4 150 vl undetectable that was in March 2013. Is this result ok? Why is my cd4 not going up to 350?
Hi Lina,
Atripla contains the same active ingredients as Truvada and Stocrin, and so you wouldn’t expect to experience any new side effects when changing from one to the other. As with any symptoms it’s important that you do speak to your doctor about this though. I am not a doctor and I can’t diagnose these symptoms online. It is therefore important that you do try to see your doctor sooner than April to establish whether these symptoms are related to Atripla, or to another health condition.
HI I been taking Trvada and Stocrin for the past 5 years, and my Dr. Switch me in to Atripla one month ago but since then I am having stomach pain with nausea plus bad headache. Am so worried cause I been taking some medication that will help my stomach but the pain is still there. Am out of town and am not gone able to see my Dr. Until April, so do u have any idea this pain related to the Atripla cause I can’t stand the pain and am suffering so much, I really need help thank you.
Hi Lungile,
When did you start treatment, and when did you start vomiting? Your doctor should be able to give you an anti-nausea drug if you are vomiting, but it is important to find out what is causing this.
Hi my cd4 is 90. Doctor gave me purbac, novavite and odimune. I vomiting all the time plse help
Hi Mabongy,
I’m glad to hear you are doing so well on your treatment! Good luck with your next test results!
Hi I started taking Tribuss in October 2012. My CD4 was 198 and I felt very tired with no power to do anything. I felt like I gad flu all the time. But since I started on Tribuss I feel like I’m born again. I have no sickness anymore! In March 2013 I’ll check my CD4 and I expect it to be higher thanks to this treatment working!
My CD4 is at 5. I was expecting to see it going up since my doctor prescribed tribuss but it is still dropping. I hate it because my body is starting to change. I have a rash, weight loss and this and that please I don’t understand and I dont want to die!
Hi Paul,
This is a very low CD4 count. How long have you been taking Tribuss for? CD4 counts should increase when you are on ARVs. If your CD4 count is dropping this may mean that you need to take different ARVs. What has your doctor said about this?
It is important that you get treatment for any other infections that you have. You should talk to a doctor about all of your symptoms and get the treatment you need.
ARVs can work even at very low CD4 counts, please follow this link to our combination therapy guide for more information.