Hi, I am 49 years old.I was diagnosed with hiv and hep c in fll of 2000. I began ttreatment in jan of 2001 with combivir and viracept.Since then I have been undetectable. the only side affect I can see in these past years is faciel wasting.Reciently my doctor sugested that I change my medications to Rayataz,Norvir and Truvada.Is this a smart choice? What are the risks. Thanks....

Thanks for your question.

It is sometimes hard to think about changing meds when their main effect is working fine...keeping the virus undetectable. But sometimes the side effects may be important to making a change. Changing from an unboosted PI (viracept) or a boosted one (norvir + reyataz) is a stronger option for sustained control of the virus. The zidovudine in combivir has certainly been associated with facial waisting and a switch may keep it from getting worse, but some studies indicate that after being on meds for 3+ years it may not get much better. Of course a change may come with new side effects but since there is no drug resistance in the background substitutions could be made more safely.

Best, Joe