I have been diagnosed for 12 yrs, and have been more or less stable, no opportunistic diseases so far. My latest lab was 4500 copies (ranging recently between >50 and 9000), 189 t-cells (never higher than 350, but the lowest in years). I have been on Combivir/Crixivan/Viracept/Viread for almost 4 yrs now.

Although I am struggling with diarrhea, my greatest concern is weight loss and facial/limbs/buttock wasting. I am 6'3" and was 206 in '96, 180 in '98, 170 last year, then dropped to 160 in May and again to 151 a week ago after a severe GI viral diarrhea; I am still at 151. This has me alarmed since I still work delivering parcels and driving a truck, but my energy poops out in the evening. I am lucky to have a loving HIV- wife, but my libido has gone south too.

Now my MD is enrolling me into a clinical study, and upon receiving my genotype/fenotype tests, called & told me I would be keeping the Viread, dropping the others, and adding two new meds plus the study med, for therapy optimization purposes. He's really focused on keeping my viral count low and my T-cells high, but does not concern himself too much with this weight issue of mine, whereas I feel I cannot drop another pound. I am taking Juven packets, a daily multivitamin, the occasional Ensure can, some Megace for appetite, and I do all my meals and snacks, generally with appetite, but I see no improvement.

Now I feel intermittently anxious and depressed over my weight and wasting, and it takes a lot to get me down. And now I visit your site and learn about thymidine/nucleoside vs. fat friendly meds, plus uridine, serostim... a bit overwhelming. Any suggestions for MY case?

For fat loss, switching off the thymidine analogue (AZT or D4T) can be helpful. The effectiveness of uridine supplements is under study and it is unclear whether uridine supplements would be helpful if one is no longer taking D4T or AZT. It is still important to control HIV and maintain a decent CD4 count since failing health due to AIDS will often result in weight loss/wasting with direct negative health implications. Efforts to maintain good nutrition and hormone status (often free testosterone levels will be low which can be addressed with testosterone supplementation) are also important to maintain body weight. KH