d4t for AZT?
May 13, 2008
We live in Cambodia and my girlfriend is in a free program and has been on a combination of NVP/3TC/d4t for almost 3 years now.
Her progress has been quite well with increasing CD4 counts and an undetectable VL.
However, she started experiencing lipoatrophy in her face and the clinic suggested that she change the d4t to AZT.
I researched d4t and see that it no longer is suggested due to its toxixity. So we went ahead and made the switch about 15 days ago.
She seems to be tolerating it quite well.
Unfortunately, I did not look much into AZT and now see that it also causes lipoatrophy. Was this a mistake to switch to AZT?
I imagine that the reason that she was switched to this is the cost, but have we just jumped from the frying pan into the fire?
Response from Dr. Pierone
It is not a mistake to change to AZT from d4T but it is not the optimal solution. AZT is less likely to lead to progressive fat atrophy, but it may still occur. Studies have shown that tenofovir (Viread) is a better option. Abacavir (Ziagen) would work as well, but there is a risk of hypersensitivity with this agent.
I hope this information helps and best of luck!
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