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Lipodystrophy and WastingLipodystrophy and Wasting
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Should I Switch?
Jul 23, 2001

I have been taking D4T,Sustiva,and 3TC for exactly one year with great results. (Undetectable and 125 increase in CD4) Although I have noticed a larger stomach, skinny legs, etc, the past 90 days it is evident that facial wasting is progressing at a rapid rate. My question(s) are as follows: Should I switch D4T for something that may be less deleterious; When does facial wasting end; Can one get by with only two drugs; Would switching to a lower D4T dosage help? Thanks for taking the time to answer this. You all do a great job for us Poz people.

Response from Dr. Dieterich

You are welcome. It is a pleasure trying to help. I am glad to hear that it does. First of all ask your MD to check your serum lactate. If it is elevated, you should certainly switch. D4T has been more closely associated with fat wasting than has AZT and abacavir(Ziagen) although all drugs of that class can do this. If you do switch to AZT or ABC, the fat wasting in the body will almost certainly stop and may get better. The cheeks are harder to predict. If you are going to change, I would not lower the dose, just switch drugs. Good luck! DTD

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