|I want to lower my lipodystrophy and my trigs
Dec 11, 2009
Hello Dr, I love your site. I have been on a two drug regime (Reyataz + Norvir with Sustiva) for 6 years and still undetectable with CD4's around 600. I have been positive since 1992. My trigs won't go under 600 even though I am taking a lipid lowering drug and I also have lipo big time. I am resistant to all nukes. My doctor wants to change me to Prezista + Norvir and Isentress. My question is wouldn't it be better to change the Prezista + Norvir to Viramune? Isn't the addition of Norvir causing my lipo? My doctor said not to worry that I will be continuing a two drug regime instead of a three drug regime even though all my HIV buddies say otherwise. Thanks for any advice you can give me.
| Response from Dr. Pierone
Hello and thanks for posting.
One element of your story requires clarification. Do you have lipoatrophy or lipohypertrophy? I will assume that you have lipohypertrophy since this condition is linked to high triglycerides.
Both Sustiva and Norvir/Reyataz may contribute to lipohypertrophy and elevated triglycerides. The approach that I might consider in a situation like yours is to simply change Norvir/Reyataz to Isentress. This would result in a two drug regimen of Isentress and Sustiva. There is a tradition of using 3 drugs for treatment of HIV infection, but 2 potent agents work just as well (as you have proven with your 6 year history of dual therapy).
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