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Jan 6, 2008

I'm currently on a regimen of Truvada, Norvir and Prezista. I've read so much about the so-called toxicity of PIs and their potential effects on body fat. I've also read accounts that describe Norvir as a "dinosaur" with potentially negative effects also. My doctor says that Prezista is a "whole new type of PI" and that I should not be concerned. Is he right?

Response from Dr. Wohl

Norvir is hardly a dinosaur just yet. It is an essential component of HIV therapy when a protease inhibitor is used. The drug does have its baggage. The pill is ginormous, melts in the heat of Summer and does raise lipids. As far as body fat we are learning that we should watch what we say when it comes to protease inhibitors and this big fat white pill in particular.

Turns out most studies show that increases in belly fat are par for the course with any HIV regimen whether it includes a protease inhibitor with or without Norvir or an NNRTI like efavirenz. In addition, a couple of recent studies suggest that those on Norvir were LESS likely to lose fat in the limbs compared to those not on Norvir. So check the date of the data you are reading as it may be outdated.

Your regimen is a potent one. It is also one of the newer combos and there is not much info on long term body shape with Prezista/Norvir. If your lipids are okay, I would keep an eye on your weight, waist size and size of your arms and legs. Don't get obsessive but just keep track of how you look. If all seems well and fine, then it likely is.


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