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Lypodystrophy -- should I change meds and what to?

Jun 20, 2005

Dear Sirs, I am currently taking Lamivudine Stavudine and Sustiva with Septrin, and have noticed facial wastage, having had discussions with friends who have experienced this, the general consensus seems to be that Stavudine is the cause! I was initially on AZT but became anaemic and have been on this combination for almost 5 years. I would appreciate any advice you are able to give as I am soon to see my consultant and would appreciate having as much information as possible as he does not appear to know much about the side effects

Response from Dr. Wohl

It is true, stavudine is most associated with wasting of facial fat. However, if there are no other options, you may be stuck.

You could try the AZT again with close follow-up (check blood counts every week for a month). If your immune system is stronger you may not have such a bad reaction this time.

If tenofovir or abacavir is available you could switch the stavudine to one of these. Studies show that such a switch will at least stop the progression of the fat wasting and maybe increase limb (and maybe facial) fat slowly.

Good luck


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