I have been on saquinavir, lumivudine, and d4t since diagnosis in 1998 when my T4s were clear down to 35. They have slowly climbed to 300 and my viral load has been undetectable for some time. I eat and exercise quite well but lypoatrophy continues to advance over time, most noticeably early on in the face and arms but more recently on my legs and buttocks. Veins are now prominent even in the upper legs. A couple of months back, my doctor switched the lumivudine to emtricitabine but not the d4T. I have seen your recommendations on switching the d4T to abacavir or tenofovir but never with anyone who is on saquinavir. Is that an option for those on saquinivir as well? I am increasingly concerned about continuing with d4T. Thanks for any advise you can offer.

I would not have any concern over the saquinavir which is generally a well tolerated drug. There are no interactions between saquinavir and abacavir so there would be no problem changing the d4t to abacavir. The benefits of switching, however, will take > 1 year to become noticeable regards Graeme Moyle