After 2 1/2 years on Combivir and Sustiva, with no side effects, I am starting to lose weight in my arms and legs and my stomach is getting bigger. I want to switch out the Combivir for Truvada and I am wondering if this will help at all since Combivir contains AZT. All my counts are good. CD4 - 420 and vL - 208

Thanks for your post.

It sounds like you may be having symptoms of early lipoatrophy (fat loss) and fat accumulation. It's important to bear in mind that while lipodystrophy can be influenced by medications, there are other non-medication factors that also seem to add to the risk.

To this end, AZT has been associated with a small additional risk of fat loss (but apparently not fat accumulation) in a couple of studies-- switching from AZT to a non-thymidine drug (like tenofovir or abacavir) can result in slow and modest increases in the fat of the face, arms and legs.

I'd speak to your doctor proactively about your symptoms and the risks and benefits of any proposed treatment switch.

Good luck, be well. BY