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wasting without meds

Dec 12, 2007

Dear doctor, I was last year (Dec.2006) infected with HIV and got tested in spring 2007 (no symptoms then or now). My test results have been good so far (recently 677 CD4 and VL 5800). Since then I have read a lot on HIV and one of the symptoms or effects would be wasting. I understand that PI meds are cause of lipodistrophy and atrophy but when I go to the clinic I sometimes see these very skinny persons. I also read somewhere that HIV may be cause of loss of body mass, even if you do not take meds. I wanted to know if this is so and if there is something that I could do to prevent it from happening. I'd appreciate to have your thoughts/experience on this. Francis

Response from Dr. Henry

True HIV wasting is generally seen in advanced disease (persons with CD4 counts < 200). Lipodystrophy is a complicated subject and is not cause simply to protease inhibitors. Lipoatrophy (fat loss) is often related to age, low CD4 counts, time with HIV as well as use of drugs like D4T or AZT. Fat gain issues are complicated since fat increases are also been seen widely in the general population so it is challenging to sort out all key factors. Newer HIV regimens generally have much reduced rates of fat problems compared to regimens we used just 5 or more ago and the impact on fat is now routinely assessed when new drugs or regimens are studied. KH

Difficulty in swalloing the pills.
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