Dear docs. I'm taking viramune, 3TC, and Zerit. I've been undectable since 1997 and cd4 between 700 and 800. Originally started with ritonivir but switched to viramune when it became available.

I'm also taking pravastatin, blood pressure meds and coumadin (artifical heart valve. My most significant side effects are the elevated lipids and an almost complete loss of my skin fat in arms and legs,NO neuropathy yet(fingers crossed).

My doctor has lowered my zerit from 40 to 30 about a year ago and now to 20 mg last month, My wt is 175lbs. Is this dosage getting too low to be effective? He suggested dropping the zerit for something else (forgot which one), but having to go for monthly liver toxicity tests dissuaded him and I agreed, the NRI tests for the coumadin are enough trouble for me.

What is your opinion? Thanks for you help.

The culprit in your current regimen is the Zerit. Stopping Zerit and starting Viread in its place makes the most sense. This strategy has been demonstrated to improve lipoatrophy and bring lipids back towards normal. Thanks for posting and let us know how things turn out.