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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Body Changes
Dec 22, 2010

I have been taking Atripla for approx. 1.5 years. I had a baby immediately prior and only took Reyataz and Truvada for the last two trimesters of pregnancy. This is the totality of my treatment experience. I have noticed a bit of fat accumulation around my belly and thinning in my legs and butt. Is this common on Atripla? Does it normally happen so quickly? Perhaps I am only picking up body changes associated with my pregnancy.

Is there another drug choice that lends itself less to body changes or is Atripla okay?


Response from Dr. Henry

Body fat changes (loss of fat= lipoatrophy and gain of fat= lipohypertrophy) is seen with HIV infection and also may be worsened by some HIV regimens. Atripla usually compares favorably to other HIV regimens in the degree of fat problems but they still occur. It is difficult to recommend an alternative regimen since so study to my knowledge (or in my own experience) has shown a clear benefit when switching from Atripla to another regimen. Drugs to at least consider might be raltegravir or mariviroc for the efavirenz but I say that with no good data. Switch options depend on availabilty and treatment history. In some cases family genetics may play a key role (comparing your body fat distribution to other family members without HIV can provide some clues there). Diet and exercise and other metabolic factors can also be involved so a clinical assessment focusing on those issues may be worthwhile as well. In many cases it may not be easy to address/reverse the situation given our current state of knowledge and limited effective treatment options. KH

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