For several years now I've been on Atripla. It's an easy pill to take with very little side effects and although my T-cells have never gone above 400 my viral load has been undetectable and I feel great. However my last test showed viral load at 2,600. Now my Dr. wants to switch meds.

2 Questions:

1. The new combo is: Reyataz, Viread, Norvir and AZT. Is this a good idea? I'm concerened about potential side effects like fascial wasting with all thses meds. I've had problems with it in the past.

2. Should the blood test be repeated first to rule out if this was just a blip?

Thank you.

Thanks for your question. I am sorry to hear about this recent blood test.

It is unusual for a combination that has kept your viral load suppressed for years to suddenly fail. Usually this happens if a person starts to miss doses or starts a new medicine that causes an interaction that effects the blood levels of the treatment.

The height of the viral load is high for a blip, which is usually below the 400 range, but repaeting the blood while obtaining a resistance test at the same time might be a reasonable approach to both confirm the result and plan for the best treatment option after the switch.

In most early failures on Atripla the virus has just gotten resistant to one of three the meds in the pill and simpler changes can be made. If the viral load has been up for a while (how long ago was the last undetectable?) than more extensive resistance may have developed and more changes may be needed. You should discuss this with your doctor.

Joe