hi, i'm w,38, poz since 84 & I startet with therapy in97 (3tc,azt) but after one year (not so good results) i changed to: d4t,ddi,nfv- with very good results: cd:406 33 hiv17 but soon i had serious problems with lipodystropy (breast&abdomen-explosion).. and so I stopped everything! now, after 1 1/2 years drug-holiday, (body is still looking the same horrible way) I'II restart with HAART: ziagen, videx, kaletra NOW-my cd4:200 16 Hiv-pcr40'000 so what do you think, how long will this combination work....do i have still other HAART-options?? are new medicines 'coming soon'?? what do you know about abdomen-fat; does ANYTHING help (any medicine?) Thank you so much for an answer......

Your options really depend on how well you can tolerate the medications and whether or not you have resistant virus. It sounds like you have never been on a non-nucleoside reverse transcriptase inhibitor such as efavirenz (EFV, Sustiva) or nevirapine (NVP, Viramune) so you still have options there. Depending on whether you developed resistance while on nelfinavir (NFV, Viracept), you may have a couple of combinations with protease inhibitors. Your doctor and you chose kaletra (lopinavir/ritonavir) which is a very potent protease inhibitor. If you are able to tolerate the meds and maintain good adherence (taking your medications every day), this combination potentially could result in complete suppression of your virus for years. There are new medicines in the pipeline so I expect you will have more options years to come.

As far as lipodystrophy (fat accumulation), we do not have any treatments that are effective. There are multiple studies trying to understand why this occurs and how to treat it but at this time, nothing has been shown to work including a prolonged drug holiday like you did.