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Lipodystrophy and WastingLipodystrophy and Wasting
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Off d4t, what now?
Nov 11, 2001

I'm a 33 year old male, tested positive 5 years ago, 106 t-cells and a viral load of 200,000. I immediately went on Crix., 3tc and azt. Viral load immediately went undetectable and my t-cells shot up over 500 and percentages at 28+ and holding. After 4 years I started developing nausea, so I switched meds to include d4t, 3tc and Ziagen. I had never shown any signs of fat change until then. I justed started to show wasting in my arms, legs, butt and face. I immediately dumped d4t for azt. It has been a couple of months of this, but I am scared that I might still be losing fat. I'm considering stopping meds for a while to prevent any further loss. My doc doesn't advocate this, but I'm scared. I'm a small guy, and any further fat loss troubles me greatly. Should I wait and see, or is it safe to stop meds? And can I do anything to reverse what I have lost?

Response from Dr. Fisher

I agree with your doc. I would not interrupt treatment (mainly because of your pretreatment numbers). Substituting AZT for d4T is reasonable, but we don't know wwhether you will see improvement or not (the reports/studies are inconsistent). I don't think you will risk your antiviral response with this switch. Good luck. AF

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