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What Meds Can I Change To?
Apr 16, 2006
Hi,
History - My last bloodwork had me at 1345 t-cells with no viral load (going on 10 years on the 0 VL.).
My thing is that I am still not happy with my arms, legs and face. This has gotten to the point that I totally cover my body up and don't go to the gym cus I figure nothing is going to make me look better. For god's sake, I am a personal trainer and fitness instructor, and really don't want to give it up.
I started meds in 96 and was on epivir, zerit and crixivan. In 99, I switched the crix to sustiva, after hearing that the crix was a big reason we were developing lipodystrophy. Then come the horror stories about zerit, so I swiched the zerit out and doc put me on combivir. Now I am hearing that AZT is as bad as the zerit. I am almost done with meds.....LOL.
I have a friend who is asian and has been positive longer than me, but doesn't exhibit any lipoatrophy of any kind.
My question is - in 2006, is there a combo I can go on that will not cause lipoatrophy? I am asking this in the hopes that I can get some sise back in my arms and legs. Please let me know what these meds are so I can talk to my doctor about them.
Thanks,
Dom
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Response from Dr. Daar
Hi Dom,
Thank you for posting your question.
At the current time data regarding the cause and management of lipoatrophy (loss of fat in arms, legs and face) is not completely known. However, the most promising data suggests that stavudine (D4T) is probably a major culprit, and perhaps zidovudine (AZT) to a lesser extent. There are several studies demonstrating that when either of these drugs is switched to either abacavir or tenofovir the amount of lipoatrophy decreases. However, the reversal of this process is slow and may not be apparent for many months.
It is important to note that any change in therapy carries with it risks and it is important that you discuss all of these options with your provider before making any change.
Best,
Eric
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