How to manage the side effects of Atroiza in HIV?

Question

Hello doctor,

I am an asymptomatic HIV (human immunodeficiency virus) positive male with a CD4 count of 320. I started on Atroiza and Cotrimoxazole two days ago. But yesterday I drank and could not sleep, and sat outside at night because I could not breathe properly. My problem is that I am on holiday now. My night shift job starts soon.

I do not think I can cope with these new side effects in this job. I really need this job, but I am afraid to stop the treatment after two days and for the duration of the holidays, as it may make the virus resistant. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

Atroiza is a combination antiretroviral therapy (ART) used to treat HIV. It includes three medications: Efavirenz, Tenofovir Disoproxil Fumarate (TDF), and Emtricitabine. Among these, Efavirenz is most commonly associated with side effects like insomnia, vivid dreams, anxiety, or nighttime restlessness, especially during the first couple of weeks after starting treatment. These symptoms are typically temporary and tend to improve on their own as your body adjusts. It is really important not to stop ART suddenly, even if you are feeling uncomfortable. Stopping your medications can lead to the virus becoming resistant, which makes it much harder to treat in the future.

If the side effects are difficult to manage or persist beyond a few weeks, you can talk to your doctor about switching Efavirenz to another drug, such as Nevirapine, which is often better tolerated and doesn’t typically cause these mental or sleep-related side effects. Also, to guide your treatment more safely, it would help to know your HBsAg (hepatitis B), Anti-HCV (hepatitis C), VDRL (syphilis), and tuberculosis status, since these conditions can affect how ART is managed. You are doing the right thing by staying informed, keep going, and reach out if symptoms do not settle.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.