May 8, 2008
I have been HIV since 1995 and have been healthy with undetectable viral loads. I am currently taking Atripla once a day only. I noticed I have been losing weight/fat in my face, butt, and legs. My numbers look great. Any suggestions on what to do to stop the fat lost? I am asked daily by people are you losing weight.. I don't want to continue down this path so I was hoping there was something else I can take. Can I stop taking the medicine? Help please. Thanks in advance.
Response from Dr. Pierone
Based on currently available data, Atripla appears to be the regimen least likely to result in lipodystrophy, but it can certainly occur. Whether some of the newer agents, particularly Isentress will be more fat friendly than NNRTI's, is not yet known yet.
So what to do?
Facial fillers represent the first line for management of facial lipoatrophy. The two agents approved in the United States are Sculptra and Radiesse. There are patient assistance programs available to facilitate access to these medications. However, there is a injection fee in addition to cost of the fillers and these rates vary considerably.
Stopping treatment may be an option. Treatment interruption has fallen out of favor, but some patients are on therapy for many years with normal CD4+ lymphocyte counts and may be able to get off medications for a while. This is not on option for everyone and stopping treatment has to be carefully considered and discussed with your clinician. Aside from stopping, a change to an Isentress-based regimen may be considered, but not based on hard data.
I hope this information helps and best of luck!
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