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Beginning therapy and lipoatrophy

Feb 7, 2007

Hi, First, thanks for a very helpful website.

I was diagnosed with HIV in 2004. My T-cell is now 240, viral load 167,000. My doctor now wants me to begin treatment. I have qualified to participate in a study in which I will receive meds free of charge for 3 years. Very grateful about that! I will be placed on Truvada and Combivir. My questions: Is this a good first-time treatment combination? What are the risks of lipoatrophy with this combination? I am athletic and slender.

Thanks for your answers.

Response from Dr. Henry

There is little data on use of that 4 drug regimen (thus I cannot give a very specific answer to your excellent question) utilizing all nucleoside reverse transcriptase inhibitors (NRTIs) which is why use of that regimen should be as a part of a carefully monitored research study. There could be considerable pressure on mitochondrial function from a 4 NRTI based regimen including a thymidine analogue (AZT) which could theoretically result in more fat problems but that issue would likely be carefully evaluated in the study. The standard effective initial regimens use in the US utilize either efavirenz or boosted-protease inhibitor based therapy. KH

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