Thanks for answering my query on Drastic body change. Currently CD4 375 Viral u/d lowest cd4 was 224. 32yrs old 10yrs HIV+ general good health abit of improvement on fat on the butts legs and arms since change on Meds. On Nevirapine+Lamivude+Zidovudine for the last 3months. Now ankles swelling, feeling sleepy all the time and change of pigmentation on my nails, feets around the soles, and also getting darker. What is the problem and which could be the offending drug?? Please helpppppp URGENTLY. My Doc in Africa is not very experienced on HAART. God Bless, Thanks a million

Increase pigmentation as you describe is often due to the AZT which I see in both Africans and African Americans in a small percentage of patients on that drug. Swelling in ankles is rarely due to the HIV meds/ Kidney, liver, and heart related problems as well as nutrional status or some process that could be obstructing blood or lymph fluid flow out of the legs through the pelvis/abdomen are all conditions that merit clinical evaluation since they can result in swelling in the legs/feet. KH