Hello

I have a question about weight loss. I started HIV treatment on Sustiva/Truvada 3 weeks ago. I was diagnosed in Nov 02. My numbers were at 520 tcells and 58,000 VL when I started treatment 3 weeks ago. My VL has never been above 145,000 and averaged around 20,000 since 2002, and my tcells have never gone below 450. I have always been asymptomatic. My doctor recommended I start treatment because my last 3 tests have shown that the VL is increasing. I have had no side effects since starting treatment except that my appetite has decreased - I am not hungry. I should mention that I am also on an anti-depressant Paxcil and that my appetite did seem to be decreasing before I started the HIV meds but seems to be even less now. I am 5'9 and weighed 182 3 months ago, I now weigh about 170. Any feedback you can provide is appreciated. Thank you.

Most patients tend to gain weight during their first year on HIV treatment. Certainly the efavirenz (Sustiva) and less often the tenofovir can cause GI or appetite changes that are usually worse in the first 2-4 weeks and then for most patients tend to diminish after that. Sustiva might aggravate either pre-existing de novo appetite problems or from effects the Paxil. I would discuss with your HIV specialist and also consider a consultation with a nutritionist. KH