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quick reply!!! wow

Dec 6, 2005

Thanks for the speedy reply. I am on the new 500mg Invirase. And I am on the "if it ain't broke don't fix it" band wagon. Here is a slight problem though-----i took truvada for a few weeks and my t-cells went up from 400 to almost 700. Coincidence? But i did not like how i felt on truvada so i went back to the invirase ( ok, i am a bad patient and playing doctor--lol). I do have some lypodystrophy/atrophy. I was actually thinking of taking a drug holiday. Does my body fat come back eventually if i stop my meds? Is the lypo an inevitable outcome of HIV--whether or not you are on meds?? Thanks for your advice. Happy Holidays!

Response from Dr. Young

Thanks for your follow up.

As for your points-- I'm not sure that the rapid increase in your CD4s was meaningful- check your CD4% to see if there was a ~40% increase- I'd bet that the % remained about the same, indicative of no clinically significant increase.

So, I'm assuming that your on saquinavir (Inverase) with 3TC (Epivir) still. Neither of these are strongly associated with excess risk of lipoatrophy or lipoaccumulation. Given this, it's more likely that your fat changes may be due to the bad luck of having HIV for a very long time or perhaps because of having a low historical CD4 cell count (CD4 nadir).

While we all like playing doctor from time to time-- so to speak, it might be a better idea to let your doctor know about your concerns and needs. Stopping your medications might be an option, though this may not result in significant improvement in body fat (though it might). Patients with low CD4 nadirs tend not to be able to maintain their holidays very long before counts drop to low levels-- because of this, I'd want to know more about your medical history before making any recommendations about stopping.

I hope this helps. Happy holidays to your too. BY

change of therapy
Delay in my doctor's appointment

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