|so much info but no real answers
May 28, 2003
Drs. I appreciate all your hard work at answering these many questions about lipdystrophy. I've read everything and still wonder "what do I do?". I'm a relatively healthy 40 y/o white male living with AIDS and have been on Crixivan, Norvir, Epivir, and Zerit for quite some time. This combination works great BUT my body hair (especially on my legs) has fallen out, I have a pretty significant buffalo hump, and the veins in my legs protude quite a bit. Now I know it's pretty much vanity and not a clinical thing but my buffalo hump seems to push my head forward and my neck does hurt most of the time. Being on disability and without a RICH HUSBAND expensive treatments and Park Avenue plastic surgeons are probably not in my future. So, I live with this right, and remain grateful that there are medications keeping me alive that many of my lost friends didn't have?
Response from Dr. Moyle
Dear Jimbo, there are a couple of seperate issues here....dry skin and hair loss are likely to be an effect of the Crixivan and not really part of the fat loss problem. Swiching your Crixivan to alternative PI, for example saquinavir or Kaletra (and in the near future atazanavir may be an option) may help these problems really quickly. The fat loss is more of a challenge. Talk to your doctor about the possibility of swiching your d4T to another drug, the most well studied option being abacavir (ziagen). Additionally, some antidiabetic drugs, such as rosiglitazone (Avandia) are being investigated to both helf restore fat but also reduce fat accumulations like buffalo humps. Keep watching out for studies on these approaches. When you talk to your doctor about these problems you may find that you may not only be able to keep on being well but also improve your quality of life
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