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Afraid of Change
Nov 27, 2004

Dr. Lee,

I have been positive for 2 1/2 years and I am currently on Invirase(4 caps once a day)and Kaletra(3 caps once a day). My VL as of 11/17/04 was undetectable and my cd4 was 384. I am losing fat around my, thighs, legs and buttocks. I feel that Kaletra is the cause. What should i do to relieve this? Do recommend a change in meds? i have read abouth the side effects of the other meds and I am very scared.

Afraid of Change

Response from Dr. Lee

You have not indicated why you are on this unusual regimen (only one class of medicine). If your virus is undetectable, it must be working for you. So, consider changes carefully.

Fat loss can be associated with HIV infection without any medicines at all. There are some antiviral medicines which are thought to make the fat loss worse (mostly the nucleosides, rather than the protease inhibitors). The Kaletra is unlikely to be causing these changes. Your fat loss may not be attributed to the medicines, but to more general changes related to being infected with the virus. I suggest that you carefully review with your doctor which treatments you have previously taken and why you changed. Then you can decide what other treatment options you have (and what the potential side effects may be) and whether it is worth the making a switch.

Be well.

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