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Will switching to Atazanavir reverse the weight gain and fat deposits?
Aug 5, 2004

it has recently been recommended that I stop taking nelfinavir and replace it with atazanavir boosted with ritonavir in order to halt the progression of lipodystrophy. I will continue to take nevirapine and 3TC. What is the evidence that this will be effective in halting the weight gain and will this treatment actually reverse the symptoms? I there anything to suggest that it may cause lipoatrophy? Is this my best option bearing in mind I am unable to tolerate AZT DDC, D4T and indinavir due to side effects as opposed to viral failure?

Response from Dr. Conway

This is an interesting question. The regimen you are now taking carries a limited risk of any lipodystrophy. This being said, there are a few case reports of reversal of body shape abnormalities following a switch from another protease inhibitor (although not nelfinavir) to atazanavir. Also, the single drug switch from nelfinavir to atazanavir carries little risk if your viral load is now undetectable and it will simplify your regimen, albeit by only one pill. If you do make the switch, bear in mind that there is no guarantee that it will reverse any body shape changes that have developed. I hope these comments help in your decision making.

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