Q and A

Question

There was a stock out of ARVs, what is the risk?

I am on Odimune (Atripla) since 2012 June. My CD4 was 350 and viral load was 18000. In January 2013 CD4 was 450 and viral load less than 50.

I had to skip my treatment for two weeks because of delays in posting of my medication is this going to have a negative impact on my CD4 and viral load?

Answer

Hello,

I’m sorry to hear that you missed a few doses of Odimune because of stock problems. Has your clinic resolved this to prevent this happening again? Unfortunately this problem is far too common in South Africa. The Treatment Action Campaign are campaigning to improve this – you may want to get in touch with them for information about this, and what to do if this happens again.

It’s difficult to say whether or not this will have a negative impact on your treatment. Missing doses increases the risk of developing drug resistance, which would mean you would need to change treatment. The risk is probably lower if you stopped suddenly for two weeks and restarted, and higher if you try to spread your meds out to cover this period. But a lot of this is unfortunately down to luck. When you missed doses your viral load will have gone up, and it’s possible during this time that you may have developed resitance. The actual risk is probably quite low from a once-off, but the only way to know will be to monitor your viral load and make sure this stays below 50 and doesn’t go back up. See this link for more information about missed doses and drug resistance.

Make sure your doctor knows about these missed doses, and ask him/her to check your viral load now that you are back on treatment to make sure this is being kept down.

84 comments

  1. Lisa Thorley

    Hi Lebo,

    Yes you need to continue. You should also tell your doctor that you’ve missed 4 days worth of meds. Your doctor may wish to check your viral load. Your CD4 won’t be effected as it’s just been 4 days without meds.

  2. Lebo

    I’ve missed 4 days of my meds is it still owk to continue….and if so is it gonna affect my CD4 count

  3. Lisa Thorley

    Hi Nexy,

    It sound like you’re talking about a health care system that isn’t in the UK. As this is the case you’ll need to either contact a local HIV org or ask your doctor how things work.

  4. Nexy

    Hey there i need to know something here.first time i went to the clinic i was 2mnths pregnant they first test me and findout i was hiv positive they gave me treatment ok now im 4mnths pregnant i need to use my medical aid by being on chronic and also involve doctor who will always moniting me when it comes to treatment tel me is possible to do that?

  5. Lisa Thorley

    Hi Mea,

    Missing three days of ARVs wouldn’t do this to your brother. Therefore this is something that will need to be discussed with your brothers doctor. My question would also be, why did he miss 3 doses of ARVs? ARVs need to be taken daily for them to be effective.

    It’s common for people who are positive to also get TB, so being on TB medication will help.

    If he’s ill then he’ll need to continue to have specialist care, this is especially important if he has a low CD4 count.

  6. Mea

    My brother is in trouble. He is HIV positive and the doctor told him he has pneumonia. He took the treatment and finished it. Then he continued to have difficulty breathing and we took him to hospital. Xrays we done and he was told he has TB and given a TB treatment to start tomorrow. (12 September 2019) He was in hospital for 4 nights of which fir 3 nights he wasnt given his ARVs. Now hes worse than before and Im wondering if its the side effects of TB treatment or the 3 missed ARVs. Hes shivering a lot and having extreme breathing difficulties.

  7. Roy Trevelion

    Hi Angie,

    I’m sorry to hear there was a stock out. But it’s good that you’ve got the medication again. How long have you been on HIV treatment?

    And what does the clinic say about this? They should be able to advise and help with this.

    What country do you live in? Please let us know.

  8. Angie

    Hi i there was a delay for my Treatment for almost 13 days , and i am 7 months pregnant is there a huge risk for my child please help

  9. Lisa Thorley

    Hi Josun,

    By LTE are you referring to ARVs? If you are, then it’s not advised to miss 3 days worth of meds. However, you should be OK. As in, your viral load should be OK. However, if you have missed 3 days, you may wish to have a viral load test.

  10. Josun

    I am not able to take my LTE for about 3 days. Is this something alarming?

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