I was diagnosed with HIV in 1993 and have tried many meds since then. I am sensitive to most of them, however never experienced any side effects, besides of face lipodystrophy. I am taking Sustiva and Trizivir for quite some time now. However, my doctor wants to change my meds because my Tcells are decreasing (181)and my Viral load increasing (22.911). Ou plan is to change my meds to T-20 (injection) plus Reyataz. My doctor also wants to add protease inhibitors, but I don't want to because of my lipodystrophy. What do you think that I should add to the T-20 and Reyataz? I hope to hear from you soon. Thanks for your help.

Unfortunately, this will be more dictated more by your resistance results that risks of lipodystrophy. Most likely you will need to include at least 1 other PI (reyataz is a PI but one with fewer lipid disturbances) and a small dose of ritonavir. In addition, it may also be necessary to include 1 or more NRTIs. This is about getting your virus undercontrol. Nonetheless, regimens that don't contain NRTIs (such as PIs+T-20) should allow fat to recover over time and some NRTIs, like abacavir, 3TC and probably tenfovir don't seem to contribute to lipodystrophy, enaling fat to recover. So it is possible to have a 'salvage therapy' regimen that doesn't make lipodystrophy worse.

Regards Graeme Moyle