Dear Doc,

I have been on AZT+3tc+Viracept for around 7 years. I feel fine with some little high chores. I have lipo problem on face and limb. I have asked my doctor if I could change med especially Zerit, but he told me that it would be better to stick to the same med as it gives a good result to me. My CD4 is 604. Viral load not test (guess it is undetectable). If I change, then I might have a resistant.

What do you think?

bests.

Thank you for your post.

Without more information it is difficult to assess what can be done safely. If you have never had detecable virus on therapy, then in all likelihood you do not have any underlying drug resistance and should be able to safely change to another regimen. There is data suggesting that people who switch off of AZT will experience at least a reduction if not reversal of lipoatrophy. In this case the best data is with switching to abacavir or tenofovir. Much less is known regarding the benefits of switching off of viracept, although there is at least on study showing that lipoatrophy was worse in those on AZT and viracept than AZT and sustiva-containing regimens.

It is important to note that anytime you make a change in therapy there is a risk of viral rebound and new toxicities. While I suggest above that a change may be possible, I would defer to your provider who knows you and your treatment history best.

Eric