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Facial Wasting with Reyataz/Norvir/Truvada

Jul 4, 2011

Hello, I've been on Reyataz/Norvir/Truvada for about 2 1/2 years and have started to notice signs of facial wasting. Other people have noticed this as well. Otherwise, I have no other side effects and have undetectable viral load and cd4 of 350.

I spoke with my doctor and he says that the most likely culprit would be the tenofivir in Truvada. He suggested that I could change to Reyataz/Norvir/Emtriva/Isentress. He said that there was no guarantee that this would stop the facial wasting. Also, he has not prescribed this combination before, but stated that he feels confident that it would work as well in controlling my HIV.

Could you give me your opinion and advice on this?

Response from Dr. Pierone

Your current regimen has a boosted protease inhibitor Norvir/Reyataz and two nukes Truvada (emtricitabine +tenofovir). The nukes are linked to development of lipoatrophy and this is one of the reasons there is increased interest in nuke-sparing regimen.

The good news is that boosted protease inhibitors are very potent, so two additional antiretroviral medications are generally not necessary to maintain virologic control. Although the guidelines would recommend 2 additional agents, I have used Norvir, Reyataz, and Isentress successfully in situations like yours. As your doctor said, this may not stop the facial wasting, but changing your regimen would be a reasonable first step.

I hope this information helps and best of luck!

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Being switched from Kaletra and Truvada combo to Atripla

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