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facial wasting treatment

Aug 5, 2013

Hello Dr., I have been on hiv meds for over 10 years and I'm 41 years old. As of january 2013 I requested to change my meds from viracept, viread and abacavir due to begin signs of lipoatrophy (sunken cheeks less fat around mouth and forehead). My meds were changed to Isentress, edurant and abcavir, The facial wasting continues. I did visit a sculptra dermatologist and he stated the i wasn't in stage 1 of lipoatrophy. He refused injecting any sculptra. What do you suggest?

Response from Dr. Pierone

Hello, and thanks for posting.

There is no evidence that I am aware of that changing a regimen as you have done will lead to any improvement in lipoatrophy. The nukes (Viread and abacavir) are the medications most closely linked to lipoatrophy, and abacavir is probably more of an issue than Viread.

Would Edurant and Isentress be potent enough to control viral replication? No study has been done. However, I have treated patients with Isentress and Intelence only (as a nuke-sparing combination) with good results.

In my opinion, even stage one lipoatrophy is worth treating with facial fillers. Why wait until the lipoatrophy worsens when it will more difficult to reverse? A second opinion with another doctor seems to be in order.

Best, Dr. P

pmma for face
Artefill in Dallas

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