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. Josh Peasegood

    Hi Londi, yes you can continue your medication. 2 days is unlikely to cause an issue. Please see this previous questions: https://i-base.info/qa/14240 Your unborn is safe. Getting back on track with your medication is the best way to keep both you and baby safe. Is there a reason you have missed these doses?

  2. Londi

    Hi I’m currently 6 months pregnant and I have missed my medication for 2 days, can I continue using them at the normal time on my third day please help I’m stressed… And is my unborn saf?

  3. Josh Peasegood

    Hi Puti, can I ask why you are having this difficulty with taking your meds every day? It is important to keep on track of taking your meds to make sure HIV stays suppressed in the body and to prevent HIV becoming resistant to the meds you are taking.

    Have you tried using a dosette box? This is a box that will split your meds into daily doses so you can keep on track of it. Or you may find that you can build it into your routine and it will become second nature, perhaps building this into your morning routine alongside breakfast? Please see this link about the importance of adherence : https://i-base.info/guides/starting/adherence

  4. Puti

    Hi I am t
    Asking meds but stretching them maybe taking them at the wrong time because I forgot or not taking them at all sometimes. Maybe taking them 43 times a week. How big is the risk?

  5. Lisa Thorley

    Hi Doris,

    Though you’re having issues, your HIV is under control. Can you please confirm what ARVs you’re currently taking? Are you taking any other medication, other than ARVs?

  6. Doris

    Hi
    Im worry for the 8months now always sick, dizziness, ringing in my years, migraine, severe body weakness, anaema, i suspect my hiv medication is causing me this site effects. I was place on Dolutegravir/lamivudine/tenofovir on September and i started having all this site effects, my doctor has to change my medication to triumeq, presently im taking but Rezolsta my health situation is still a problem, this is affecting my daily activities, i can not work always sick. My cd4 is high and the viral load is 44. My worry is how can i have pills that will not give me grave site effects like this ones. Bc right now this new pills immediately after taking it i will have heart burn, vomiting blood, dizziness, vertigo, ringing in my ears , insomnia, severe headaches. Palpitations. I have talk to my doctor about.

  7. Simon Collins

    Hi Rebecca, this sounds like a complicated situation. If your husband really did stop his HIV meds then his CD4 count might now be very low. This means that he might have other complications including dementia. He might need special support to take his meds again now. Restarting treatment might improve the cause of the dementia and not starting will continue to make it worse. However he need to speak to his HIV doctor to get more deatialed tests and support. Is there any chance your husband will let you help him?

  8. Rebecca

    My husband is HIV positive and we had split up and he moved away and have recently got back together.

    I have just been told that he quit taking his antiretrovirals 7 months ago. I thought he was being dishonest about things and I am severely uneducated about his HIV and I have come to believe he has dementia.

    I don’t know what to do he has kept me out of his medical appointments and seemed to always have his appointments and medications completely under control. I have thought my husband was doing drugs and was just needing more information when he called the HIV clinics.

  9. Roy Trevelion

    Hi Katlego,

    I’m sorry to hear this side effect has made it difficult for your daughter to take the meds.

    And yes, it’s a good idea for her to go back to the clinic. She can ask for other meds that will be easier for her to take. If you live in South Africa you can contact the Treatment Action Campaign at this contact link. They can offer your daughter local support to help access better treatment.

  10. Katlego

    Hi I have a problem my daughter stopped taking her meds for HIV for three months because they make her vomit but I have advised her to go back to a clinic to take her meds, will it still work if she start to use ’em again

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