AIDS/and AZT

[mewithu]

Is AZT bad for you and is a cause for lipo

[Miss Philicia]

Define "bad for you" and otherwise I'd say 95% of HIV meds list lipo from the NRTI class, but then so do a lot of PI's though to a lesser extent perhaps.  Kind of hard to build an effective HAART regimen with zero chance of lipo, so it's a bit of crap shoot you know.  Genetics make many of us more prone to it than others, but I see now way to figure that one out in advance.

Put it this way, it's widely viewed that AZT is less prone than other NRTIs like zerit, videx and hivid (the latter isn't prescribed anymore), and I'd say that's been my personal experience as I've been on all 4 of these meds in the 90's, but my lipo appeared years after going off AZT but on the others.  Of course, it takes times for a metabolic dysfunction to become apparent so even in that regards it's rather difficult for me to say exactly what did what, but that's the timeline that seems feasible in my mind.

Bottom line for me is that I don't see, and never have, AZT in as harsh a light as some people seem to -- and frankly this paranoia is mostly a result of it being the oldest HIV med and people recalling that many died while taking it, forgetting that it was given at that time in the late 80's/early 90's at higher doses, and in only mono or dual therapy, not current HAART regimens.  Otherwise the most "bad for you" stuff I felt was a periodic headache.

[MarcoPoz]

Your treatment decisions should always be made in consultation with your Infectious Disease Specialist.  Those of us here who are either on AZT or have a history of taking it can only tell you what our personal experience might be with it.  You will probably there see an entire continuum of responses which would by their variety and diversity render the information fairly useless as a motivator for your treatment selection issues.  That being said--I've been on it in some form/dosasge or another since 1991.  Here's some of the published side effects:

Zidovudine may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and gradually get worse. Symptoms include unusual muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if you have any of these symptoms, even if they are only mild. Early signs of lactic acidosis generally get worse over time and this condition can be fatal.

Zidovudine can also cause severe or life-threatening effects on your liver. Call your doctor at once if you have any of these symptoms while taking zidovudine: nausea and vomiting, diarrhea, loss of appetite, stomach pain, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). 

Do not use zidovudine together with other combination drugs that contain zidovudine, such as Combivir or Trizivir.


Bottom line--make sure you discuss your treatment decisions with your physician too.

[mewithu]

Hi, Thank you for responding to my add. The main concern was the wasting but you got me thinking now of other  things it has done, possibly I say. Because they would have to test for these other things I Imagine.
Anyway Thanks for caring Dude.

Sincerely,
Jerry

[aztecan]

Hey Jerry

Actually, wasting and lipoatrophy are two different issues and are not related.

Lipoatrophy can be caused by some if not most, of the meds. The exceptions may be the two new classes of drugs, but, since they are new, who knows? Your genetic makeup also may play a role in whether you suffer lipoatrophy, or lipohypertrophy for that matter.

Wasting is a sign of advanced HIV disease, usually at the stage when it is labeled AIDS. It is not caused by the meds, but by the body's losing muscle, rather than fat, thanks to the long-term onslaught of HIV, or, in some cases, a short term, very virulent onslaught. This also sometimes happens when people have suffered some of the opportunistic infections people with advance HIV disease get.

I read in your tag line you have been through the mill with this. I also note you are on Combivir. I have been on that combo (AZT and 3TC) for nearly 13 years. I do have both lipoatrophy and lipohypertrophy.

Whether mine was caused by AZT, or the Crixivan I took for 11 years, I can't say.

But, you say you also feel tired or fatigued a lot, as well as experiencing wasting.

I would talk to your doc about having your red blood cells checked. You could be anemic, which also can be a side effect of AZT

The bottom line is I would have a serious heart to heart with my doctor were I you.

HUGS,

Mark

[Miss Philicia]

Jerry, what Mark just said (good catch with the sig line) can't be said enough in your case: wasting and lipoatrophy are two different issues and are not related.  I've had both lipo and wasting, and I've had them occur at the same time.  The plus side is that wasting has the greater potential to be corrected -- I lost 40 lbs (twice) and gained it back.  It's now been five years since all that and my weight is finally completely stable.  On the surface it can look similar to the patient, but they need to be thought of separately.

I also have to wonder why your doctor has not put you on newer meds though.  If you think Combivir is causing lipo why not look into swapping it for an entire new class like Isentress?  Wasting is harder to solve -- I had to do years of testosterone injections, then switch to the gel to gain weight back.  That solved any appetite issues though you don't say if that's a problem for you.  Also helped with fatigue, so I got back in the gym at the same time.