Hi, I am currently taking Combivir and Sustiva and I am undetectable. My T cells are around 600 and my total cholesterol is 259. I have noticed the veins in my legs showing more than normal in the last six months of treatment and am worried the condition will get worse with time. My weight is around 170 lbs and I am 5'11". I do work out and eat well. I was wondering if I could switch to a different regimen that would stop the slight fat loss. I have been in a study for two years but have relocated to Seattle and have a top physician in the city. I have my first appoinment the end of the month. I know there are a lot of choices out there, but I was wanting to know your oppinion on this matter. Thank you so much for your time regarding my issue with the meds.

You are right to want to address this issue up front. Alhtough of the nucleosides stavudine is the one most associated with lipoatrophy, AZT may also play a role. With your CD4 count being essentially normal and your viral load undetectable, you can switch Combivir to Truvada for instance (functionally changing AZT to tenofovir)and almost surely keep suppressed. This will also allow you to take pills once a day, and maybe move on to the one pill once a day triple combination pill (Truvada/Sustiva) that will be available soon.