All the bad things at once!!
May 10, 2005
Hi, I live in South Africa and have written to the you like twice. I am on Videx Zerit norvir and viracept and last count had a cd4 of 251 and V load is less than 40. However, I suffer form lypo and recently took megestrol for about 12 weeks. It made me eat like a pig, and today, I have a cholestrol priblem, high tryglcerides and my tummy is like a bloated boat!!! Any time I eat I shake like a leaf, and I still shake, my doctor seems reluctant to changem my medication because it is keeping my virus in check, but please I need your help, what is really happening to me at this time? Is it the megestrol or is it the meds that has me in this state??? What alternatives can I discuss with my doctor? Some of the drugs you mention here are soo expensive or not even approved for use here in SA, I need your help doctors educate me a bit!!! O
Response from Dr. Henry
It is difficult to know what is available drug wise in your regimen. I would try to switch from ddI/D4T to AZT/3TC or tenofovir for the nukes. Usually Viracept is not used with ritonavir (not buch of a boost provided) so perhaps either the ritonavir can be stopped. If there are alternative protease inhibitor available (such as atazanavir or saquinavir) they are boosted better by ritonavir with modest to no impact on lipids/fat. Nevirapine may be the most fat friendly of the drugs so switching to if (stopping the PIs) is an option if you don't have NNRTI resistance. Exercise, diet can help with the fats some. KH
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