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Kaletra and Lypodystrophy? Drug Holiday?
Jun 23, 2004

Dr. Conway:

I have been positive for over 12 years. Current regimen consists of Kaletra, Viread and Rescriptor for past five months. VL is undetectable and T Cells 490. However, I have been noticing increased body fat redistribution to upper back. I am very concerned about these changes to my body. I work out five times per week and (3 days resistance weights and 2 days aerobic exercise). Am I going to develop diabetes? Am I a prediabetic at this time? I want to consider a drug holiday (my T cell's have never been under 450 and at highest were 889-12 years ago-and VL never been beyond 7K)is it a good idea? Is it the Kaletra that is causing the body fat changes? If so, would Reyataz be a good alternate?

Thanks for answering my questions. Esteban

Response from Dr. Conway

Of the drugs you are taking, it is clear that Kaletra is most associated with lipodystrophy. Some people with CD4 counts such as yours go on drug holidays. This is generally safe, and most often, the CD4 count will settle out no lower than its lowest recorded value in the past (for you >400, which is fine). It is still important to monitor the CD4 count closely if you choose a drug holiday.

If you stay on medication, the best approach is to get off the drugs that are most associated with lipodystrophy. With an undetectable viral load, you can make a single drug switch, and going from Kaletra to Reyataz is certainly a good option.

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