Hello. I have been on Sustiva, Zerit and Abacavir since Jan 2000. I have been concerned about the possible facial wasting. The virus has been suppressed on this mix of drugs and I am doing well. However, I have been struggling with high levels of cholestoral, trygliecerides and high liver enzymes. I have none of the hepititis - B or C , non smoker and non drinker. I am on a med for the tri's and it works well. I have decided I want off Zerit. In Canada Viread is not available yet and my doctor suggested replacing Zerit with AZT in the interim because it is the lesser of the 2 evils unitl Viread is available. I think I have some facial wasting and want off Zerit. What do you think about the AZT which i have read also is a culprit to the facial wasting. I was on AZT for 2 years. I was diagnosed in 1997 and started drug therapy then.

Your thoughts appreciated.

Most studies have suggested that fat wasting occurs less often with AZT then with D4T so that switch is often done even before any fat is lost. D4T can also contribute to the increased lipids (perhaps more so then AZT). Nevirapine may be marginally more fat friendly then Sustiva. I have numerous patients such as yourself on Trizivir + Nevirapine or atazanavir as a potent fat friendly regimen as another option (I also often use tenofovir in this setting). KH