Dear doctor,

I am 27 yrs old male diagnosed poz Dec 07 (tested negative on 06) and have seen a sharp drop on my CD4 since then. It declined from 570 Jan 07 to 221 last month. I also had resistance test which indicated K103N mutation. My doctor just started me on 3TC + Viread + Kaletra 3 days ago and by the way I do not feel any side effect at all so far.

What is freaking me out is the posibility of developing body changes. How likely am I to develop fat accumulation or loss, and how fast considering my regimen?

I swim twice a week and will also start to work out. Dont drink or smoke.

Please help! Thanks R.

Hello, and thanks for posting.

There seems to be some genetic predisposition to development of both lipoatrophy and lipohypertrophy. We do not have tests with accurate predictive properties yet, but in the future testing of this nature may become available and help us select regimens.

The risk of lipoatrophy is quite low with this regimen. The Kaletra seems to offer some protection from lipoatrophy, probably because it is associated with fat gain in some individuals. Fat gain and lipohypertrophy is the greater concern with this combination. But you may have no problems whatsoever and do well for years without the need to change anything.

If body changes do occur, they tend to develop slowly over a number of months, rapid changes are distinctly unusual. The best advice is probably to be alert for body changes and inform your physician if you see a trend developing.

Good luck!