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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Aug 27, 2002

This is just for a second opinion. After being on sustivia for 1.5 years, I continue to experience sustivia roller coaster rides- dreams, spinning, etc..

Im currently taking sustivia, 3tc, and abacavir. I do want to avoid the PIs. Is there anything with which I can substitute sustivia? My viral load is undetectable and the cd4s are moving up- quickly- close to 500, from 192 1.5 years ago.

Secondly, is 3tc (accordingly to current research, and medial intuition) anyway related to lypoatrophy?

On a closing note, Id like to say that all of the hair is growing back on my legs, which had fallen out while on PIs. Ive concluded that hair was related to the PIs because its the only class of meds Im not taking anymore.

Thanks for your efforts and dedication with this site.


Michael (Canada)

Response from Dr. Boyle

If you are intolerant of Sustiva (efavirenz) and don't want a PI, you could consider a change to Viramune (nevirapine), but the data on efficacy are not as strong with Nevirapine. If you haven't already (and you probably have), you might consider trying some medications to help your Sustiva symptoms, such as meclizine for the dizziness and zolpidem for sleep; some of my patients have had success with these medications. Regarding your second question ALL of the nucleoside analogues have been implicated regarding lipoatrophy, but Epivir (lamivudine, 3TC) is probably the least likely to cause it.

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