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start or not to start HIV meds.

Jul 2, 2005

Please help! I am in a need of second opinion. I stopped my HIV meds 14months ago, due to severe hyperlypodistropy side efect. The combination of meds that I was taking were Ziagen, Videx, and Sustiva. But my new lab test showed VL 32K and t4 236. My ID doctor is urging me into getting back to the same meds, but I am afraid because of the side effects. He incists that this combination is safe and does not cause hyperlypodistrophy. Then how do we explained my current problem with these horroble side efect? Yes my VL was undetectable but my hump was growing by the minutes. Any suggestions for different meds combo? Thank you for your time.

Response from Dr. Pierone

This combination is not particularly known for producing lipohypertrophy (buffalo hump and abdominal visceral fat deposition). However, everyone is different and we don't really know what causes lipohypertrophy anyway except that it is more commonly observed with protease inhibitor-based therapy. So it would not be advisable to change to a protease inhibitor in view of your prior experience. Also, since mitochondrial toxicity has been linked to lipoatrophy, and Videx is known for this complication, it would be logical to exclude Videx when you restart medications. Hope this helps and let us know how things turn out.

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