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Protease paunch reversible now that I'm off AZT?
May 4, 2011

Dr. Henry,

Me: 39-year-old female, long-time pozzie. I was on Viracept and Combivir for first 7 years of treatment, with no side effects. Switched to a more updated regimen in September and strangely enough, at that time started to note significant protease paunch. I'm now on Isentress and Truvada, so I'm hoping that this is a late-developing after-effect from the Viracept/Combivir, and thus reversible. I'm an avid athlete/weightlifter/runner, and this belly sticks out like a sore thumb. Hoping that now I'm off the AZT combo that this can reverse with a little focus. What do you think?

Response from Dr. Henry

Raltegravir/Truvada enjoys a good reputation for being fat friendly though a small subset of patients (for as yet unclear/unpredicable reasons) have more pronounced fat gain or loss. You are correct is thinking that the fat problems generally would be worse on your prior regimen so your situation is somewhat out of the ordinary. A CT scan to look at fat distribution (intra abdominal versus subcutaneous) might be considered. The genetic influence can be strong in some patients so carefully looking a abdominal fat distribution in close similar or older aged relatives can provide a clue there. Management of HIV and treatment related fat gains/losses remains a major challenge for many patients. KH

Abdominal and waist fat
Atripla Rash and swollen lips

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