Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
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Sustiva and Lipo
May 29, 2003
Is it true that high blood lipids are connected with lipodistrophy/atrophy?
Does Sustiva cause high lipids?
Is a combination of Viramune+Viread+Epivir equivalent to Sustiva+Viread+Epivir in somebody with no resistence and VL below 100K ?
Is the Viramune based combinatioon less likely to cause lipo but more liver toxic?
What would be your choice?
Thanks a lot for your help
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Response from Mr. Vergel
Many people with lipodystrophy have high lipids, but many others don't. In fact, new data from the new protease inhibitor Atazanavir are showing us just that. This PI does not increase lipids but lipodystrophy was observed in patients who took it.
Sustiva can increase lipids.
The 2NN study showed that Viramune and Sustiva were equivalent in potency for those with viral loads under 100,000. Viramune is less likely to increase lipids but it can increase liver enzyme in some patients. Several studies showed that people who switched from protease inhibitors to Viramune have improvements in lipids and insulin sensitivity, but their bodies did not change after 48 weeks. I always wonder if the background combo with Zerit had also something to do with that. The manufacturer is yet to do a study with nucleosides besides Zerit (the 2NN study also used Zerit as the most common nucleoside)
My choice is clear for me. I took both and I could not handle the depression I got with Sustiva. But I know many patients who take it with no problems at all. It is an effective drug for those with no resistance to non-nucleosides.
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