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Lipodystrophy and WastingLipodystrophy and Wasting
          
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azt..bad rap?
Jan 2, 2004

i have been positive for five years and started right away on d4t,3tc and viramune. after two years I noticed fat loss (especially in the face). my dr then recommended a switch from d4t to azt. I have been taking this for the last three years and have noticed that the fat loss has gotten worse. Lately i have been hearing alot of bad things with azt. I guess I assumed all the problems with it were when they used to give it in such high doses. I also hear some experts say that it is not so bad for wasting? I have read some emails in which you suggest abacavir as a better alternative? what do you think?

Response from Dr. Moyle

The data are quite limited and a bit conflicting. Some cohort data suggest benefits of switching d4T to AZT but some prospective data that indicate that persons on AZT based regimens still lose fat over time. The switch from AZT to abacavir (or possibly to tenofovir) is a reasonable consideration and may stop things getting worse or even allow some gradual fat recovery. Given your treatment history it should be virologically OK. Best Wishes Graeme Moyle


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