Question
Is Atripla making my hair thin?
10 April 2013. Related: All topics, CD4 and viral load, Side effects.
I’m a 31 year old female and was diagnosed with HIV approx 3 years ago after being hospitalised for toxoplasmosis. When I was diagnosed I had a very low CD4 count of under 60 and a high viral load. However, after starting treatment i have been undetectable and my CD4 count has risen. At the last check it was just over 500 (although the CD4% is still low at around 16%). I have noticed that the hair on my head, especially on the top left has started to get very thin. It has also been noticed by some friends and relatives. I mentioned it to the HIV doctor, but he dismissed it saying that none of the medications I’m on cause hair loss (I’m on atripla).
In your experience, could it be caused by either HIV or the medication? Could it be a symptom of an underlying condition? Or is it completely unrelated? Are there any treatments that you could recommend as it is starting to affect my confidence.
On a differing note. During my last visit to the doctor they did not take my CD4 count only the viral load. Apparently it is standard in the UK now to only take counts every 6 months or yearly. I’m a bit worried as my percentage is still pretty low and it’s only within the last year and a half that my absolute count has risen above 200. Is this standard advice for most HIV patients now or should my doctor be taking CD4 counts every three months like previously?
Answer
Thank you for your question.
I am sorry to hear that you are having problems with hair thinning. I am also sorry to hear that your doctor dismissed your worries about this. In order to make sure your doctor takes this seriously you should explain that this is affecting your confidence and your quality of life.
There are lots of things that can cause changes to your hair including stress, genetics, age, and medication. In relation to HIV medication, 3TC has been known to cause hair loss, although this is rare. Whilst you are not taking 3TC, one of the drugs in Atripla called FTC or emtricitabine is very similar to 3TC. It is possible that changing to a combination of drugs which does not include FTC may stop the hair loss from occurring, although there is no guarantee. You should talk to your HIV doctor about this.
For more information please follow these links, here and here.
In response to your question about CD4 counts it is not unusual to have your CD4 count checked every 6 months. The British HIV Association (BHIVA) guidelines for monitoring HIV suggest that the frequency of CD4 T-cell counts can be reduced to every 6 months in patients who have maintained a viral load below 50 copies/mL for more than 1 year and have a CD4 T-cell count above 200 cells/mL.
Maintaining an undetectable viral load is the most important thing while you are on treatment. This shows that HIV is being kept under control and is no longer able to replicate and damage your CD4 cells. Your CD4 count is good, so try not to worry too much about the numbers and concentrate on getting on with life outside of HIV!
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