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Various concerns on ARV

May 11, 2013

Dear Dr. Holodniy:

I started ARV in March 2009 (Efavirenz/Lamivudine/Zidovudine). Present cd4 is 489 and viral load undetectable. However in April 2009, my doctor changed Zidovudine to Stavudine because my hemoglobin count dropped to 127 from 154.

In June 2010, after more than one year of taking stavudine, my doctor shifted me back to zidovudine because of lipoatrophy (my weight dropped to 60.90 kgs. from 66 kgs.)

Last January 2013, I shifted to Tenofovir from zidovudine because of severe lipoatrophy.

Here are my questions:

1. After the shift in Tenofovir? How long will I recover from lipoatrophy (especially sunken cheeks)? Will eating banana everyday helps?

2. I drink lots of water because I'm protecting my kidney against renal toxicity. Am I doing it right? Will tenofovir and the other ARV's lose its efficacy if i drink water in excess of 1.5 liters a day?

3. Does my present ARV cause cataract? skin allergy and dry skin? Or they are caused by another HIV related medical condition. I was also diagnosed with syphillis in August 2011 but was already treated with penicillin (3 successive weeks of intramuscular injection).

Your expert clinical advice on the above concerns is highly valued.

Thank you.

Response from Dr. Holodniy

1. The lipoatrophy may or may not get better with the switch in meds. 2. No, they will not lose their efficacy. Keep doing what you are doing. 3. No, your HIV meds would not be causing those.

I stopped my HIV meds 3 months ago & I'm still undetectable and CD4 counts in 600
Vitamin D confusion

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