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Lipodystrophy and WastingLipodystrophy and Wasting
          
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acute conversion immediate therapy concerns
Jun 17, 2003

I have recently (5weeks) been diagnosed in the process of sero-converting. I have made contact with an hiv specialist who wants to start my therapy (combivir and Kalestra) probably by next week (clinical vaccine trial). I've looked through most of the replies here but haven't seen anything specific about just how soon lipodystrophy/wasting can start to appear. It's all pretty overwhelming and hoping to prepare myself psychologically for what may be coming. I've heard there are proven benefits to my immune system by starting therapy sooner? Does that move up the potential presence of side effects as well?

Response from Dr. Moyle

Lipodystrophy generally develps slowly and does not occur in everyone who receieves medication. You would be unlikely to see any changes over 12-18 months. It is less common in young people (<40 yo) who start treatment with high T cells (>200). Indeed medication is generally better tolerated from all stand points if you start when well. PIs like Kaletra are assocoated with higher risk than NNRTI based regimens so check with your doctor to see if Kaletra is obligatory in the trial. Treatment at seroconversion may have benefits but trial results vary..some show benefit, others not. Participating in a vaccine study is probably the best way available at present to investigate these possible benefits.

Best Wishes

Graeme


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