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Atripla weight gain
Sep 12, 2013

I've been on atripla since it came out in Australia, I've found I'm holding a lot of weight and the gut area and lots of bloating. By the end of day my gut is very tight and by morning it's back down to normal. I power walk twice a day for an hour each time, I've been HIV since '95 and have kept a good way of life and was a competitive sports person up till three years ago,had some depression and now off medication for that, but had alot of stress in the past few years I'm undetectable and CT4 1100 and has been always been around 7 to 8 hundred, but recently early this year cd4 went down to 340 now throught the roof. Do's Atripla have a wieght gain or bloating side effect steve

Response from Dr. Henry

Abdominal complaints/bloating and weight gain can be seen in some patients with a wide range of HIV regimens, Atripla included. Lipodystrophy with increased intra-abdominal fat can be seen with Atripla though has not been common (abdominal CT scan can assess amount of intra-abdominal fat). The problem is what to do about it if you have it. I am not highly confident in any therapy for intra-abdominal fat or in switching to an alternative regimen expecting clear benefit. It is unusual for there to be a persistent large drop in CD4 count while maintaining good viral suppression. I would usually expect the CD4 count to stabilize or bounce back up. If it doesnt (seen occasionally ie < 5% of patients) then a discussion with your HIV provider regarding whether there should be a good general health/cancer screening assessment depending on your overall health status. If intra-abdominal fat not a problem but bloating is a major issue for you then evaluation of problems like lactose intolerance, H pylori infection, side effect of a another medication, or other contributing problem. Some patients may have gut side effects from one of the components of Atripla (ie the tenofovir) so if it looks like the Atripla may have a role then switching to another regimen on at least a trial basis may be worth discussing with your HIV provider. KH

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