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Changing meds to prevent lipoatrophy?
Nov 10, 2005

Hi, I was diagnosed at the time of seroconversion (primo-infection) in January 2002, and was put since then on Combivir and Stocrin with good results (CD 4's around 700 and undetectable VL). No visible fat changes, except a little growing of the abdomen lately. I am awfully afraid of lipoatrophy though, and from my undertanding, Combivir has one component that causes it. Would you suggest my changing it to another one that does not cause lipoatrophy like Truvada or Epzicom? Or could this spoil a regimen that has worked well so far? I have no history of resistance to meds. Thanks for your help.

Response from Dr. Conway

You are right to say that the zidovudine component of Combivir may be associated with lipoatrophy in the long-term, although the risk is nowhere near as great as it would be with stavudine.

With an undetectable viral load, you can certainly switch the nucleoside backbone to Truvada or Epzicom witout compromising the efficacy of the regimen as long as adherence is maintained.

What should I do?
Stop meds

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