Hello, I would very much like your advice on a fat friendlier cocktail than the one I am currently using. I have been poz for 10 years and have been on only 2 cocktails, the first (viracept, epivir and zerit) for the first 5 years and trizivir and sustiva since then. The first switch was due to constant blipping in the last year of therapy (but my dr never ran a resistance test). I'm blipping now on current regimen - but not going over 400 yet. Mr dr doesn't want to switch me until it eventually goes above 1000 and we can do a resistance test and be certain of the new drugs. Do you think this is wise or would you suggest switching now? If so, to which regimen? I've had lypoatrophy for 7 years, so it may be too late for my body to every return to normal. Thank you in advance for your help. Jude

Switching off the AZT in Trizivir is one factor in your current regimen that could improve or at least avoid further fat loss. If you are having consistent low level viremia I would be concerned about both a M184V mutation (resistance to FTC and 3TC) and a K103N mutation conferring resistance to efavirenz. Simply dropping the AZT out of the regimen would likely weaken your current regimen and I am not confident that adding perhaps tenofovir would be enough to further control viral replication. I would often consdier a switch to a generally fat friendly boosted PI regimen such as ritonavir + atazanavir or fosamprenavir and could likely just use Epzicom lamivudine + abacavir) instead of Trizivir. KH