Dear Brian/Keith,

After two years of first-line Combivir/Kaletra therapy (the treatment worked well from the beginning and I am now at CD4: 550/viral load: undetectable), I am having some light lipoatrophy in the face and, therfore, would like to switch to a combination that is less likely to cause lipoatrophy. 1) What combination would you suggest to take next? 2)Would it be silly to take a break without any treatment? Thank you very much in advance for your time and the great work you do here on THEBODY. Best, James

Dear James:

Thank you for your kind comments about the site. As for stopping therapy at this time, recent information from clinical trials of this approach suggests that it would do more harm than good, so you should continue. As for what to switch to, the key would be to replace both the zodovudine part of the Combivir and also the Kaletra. You may wish to do this in stages, perhaps changing the Combivir to either Epzicom (or Kivexa, as it is known in Canada) or Truvada (allowing you to take your nucleosides as one pill once a day). If you tolerate this switch and your viral load stays undetectable, you could then perhaps switch the Kaletra to either Reyataz or Sustiva, further simplifying your regimen.