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likely progression of facial wasting Jun 15, 2001 I am a 35 yo male who tested positive 1.5 years ago (at that time vl = 10,000 cd4 350). Since then I have been taking Viracept, Epivir and Zerit religiously (vl <50, cd4 475). In the last six months I have noticed fat wasting in my arms and some mild wasting in my high cheek bone area. I have also lost weight in my waist and have subtle bloating in my stomach area. Others have commented (and ironically complimented) me on my weight loss in my face and my athletic looking arms. If I could freeze the way I look right now, it probably wouldn't be a problem. So here is my question: what is the likely progression of the fat wasting? Do most people continue to progress to a disfiguring point, or do some people reach a certain point (a plateau) where the syndrome no longer creates additional cosmetic problems? I understand that its not really reversable. What I'm asking is how far does this typically go? The answer to this is important for making decisons on how to proceed with treatment. Thank you very much. |
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| Response from Dr. Henry
 The course of fat wasting is still not well understood and is variable. Fat wasting has been linked to some issues one can't do anything about (aging, time with HIV)and to a good response to therapy (high level suppression with a good T-cell count recovery). Whether particular drugs aggravate the situation is being debated. D4T- a well tolerated an effective NRTI- in some studies has resulted in more fat loss that AZT. Protease inhibitors may also aggravate the problem. Switching drugs around may slow down the process. Reversing the process has been difficult partly due to the factors one can't due anything about but more likely due to the fact that we realy don't know what is going on. Use of oral diabetic drugs is being studied in this setting (the ACTG is starting a study on that as we speak). For facial wasting even plastic surgery is being utilized. To try to answer your questions, for many patients the condition has been slowly progressive. I expect better answers and treatments over the next several years. KH | ||
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