NNRTIs & PIs, & Lipo

[RobbyR]

Just wondering, because I have heard so many conflicting statements about the risks of Lipodystrophy with certain meds. First off, does it matter whether you take a PI or NNRTI? Does one have potentially more risk of it than another? Or does the lipodystrophy only apply with the older meds like form the 80s/90s? Some of my friends told me that NNRTIs are safer in regards to preventing wasting/lipodystrophy than PIs. I myself chose Atripla, an NNRTI, mainly because of the negative things about PI's I heard. I was probably misinformed, but just wanting some of the seasoned members here to clarify for me. I am currently debating whether to ditch Atripla for either another NNRTI or possibly PI..I'm considering Epzicom/Norvir, or maybe Truvada/Norvir/Prezista or T/N/Reyetaz...or, I may try I+T or the Quad, if I switch..Just wondering about the risks of lipo/wasting with PIs vs. NNRTIs. Thanks!

[buginme2]

Just wondering, because I have heard so many conflicting statements about the risks of Lipodystrophy with certain meds. First off, does it matter whether you take a PI or NNRTI? Does one have potentially more risk of it than another? Or does the lipodystrophy only apply with the older meds like form the 80s/90s? Some of my friends told me that NNRTIs are safer in regards to preventing wasting/lipodystrophy than PIs. I myself chose Atripla, an NNRTI, mainly because of the negative things about PI's I heard. I was probably misinformed, but just wanting some of the seasoned members here to clarify for me. I am currently debating whether to ditch Atripla for either another NNRTI or possibly PI..I'm considering Epzicom/Norvir, or maybe Truvada/Norvir/Prezista or T/N/Reyetaz...or, I may try I+T or the Quad, if I switch..Just wondering about the risks of lipo/wasting with PIs vs. NNRTIs. Thanks!

I don't know if NNRTI's or PI's have a better or worse propensity for causing lipo issues.  Maybe someone can answer that.

However, even if one or the other has a greater chance your leaving out NRTI's from your evalutation.  So even if you switched off of one to another, you still have a backbone of 2 NRTI's (Unless you go off label and construct something without).

[Miss Philicia]

While lipo can be listed for several medications, it's generally attributed mostly to an NRTI in the case of lipoatrophy (fat loss in limbs and face), specifically zerit which isn't generally prescribed in advanced economy countries, not has it been for a decade. The major culprit for lipohypertrophy (buffalo hump fat accumulation in neck) was the second oldest PI, crixivan. Similarly it's  not used anymore and hasn't been for a decade.

Something like Reyataz and Prezista are from a second generation of PI's so you shouldn't look at them the same as the first ones that came out. Same with an NRTI as in zerit vs. truvada.

So basically your friends don't know what they're talking about, and if they want to argue about it feel free to send them over here and I'll be happy to have a whack at them.

[darryaz]

I asked my doctor about this exact issue when I started on Atripla (because I'm vain).  He indicated that lipo was not an issue with Atripla.

And 5 years later I have no signs of it.

[RobbyR]

I too have had ZERO issues with lipo since I've been on Atripla, or any body changes for that matter. In fact, I would venture to say I look better than I ever have physically. It does have some nasty brain side effects at times though, but Miss P is correct, I don't think any of the modern PIs are any different to the NNRTIs with regard to lipo. All doctors I have heard have agreed.