Dear Doctors:

I just returned from my infectious disease doc appt. I had good news with an undetectable viral load and 735 CD4. After 3 years, my doc is suggesting taking me off Combivir (I have been taking Combivir and Viramune). He would like to switch me to something else without the AZT to lessen the chances for lipo. What would you suggest? I am not resistant to any of the meds. Right now I don't have any serious side effects such as nausea or diarrhea - and I want to stay that way. Your thoughts?

Thanks for your post.

First, if you're doing well on your current regimen after 3 years, it's unlikely to me that you'll soon develop problems.

There are studies that look at what happens to patient who have lipoatrophy and switch from thymidine analog drugs (d4T and AZT) to other drugs. Taken together, these studies show modest and gradual improvement in limb fat after switch to either abacavir (Ziagen, part of Epzicom) or tenofovir (Viread, part of Truvada).

Both options are usually very well tolerated; the specific side effects and their management are beyond the scope of this reply, but I'd encourage you to speak to your doctor about your current situation and treatment options.

Good luck, thanks for posting. BY