KALETRA AND TRUVADA = LIPODYSTROPHY????

[PLL]

I have been positive for 18 years and for an estimated 3 years have been taking kaletra and truvada.  I have noticied an accelerated lypodystrophy on my face in the past two years and have had to do facial fillers with more frequency.  I would really like to hear if anyone out there has experienced something similar and if so which of the two do they believe has caused it or if both of them have a track record for creating lypodystrophy.   I look forward to hearing from you all....

[aztecan]

Heu PLL,

Both Kaletra and Truvada can cause Lipoatrophy, but I am not aware of them being particiularly strong catalysts regarding this.

Have you noted any increases in you lipid profile since beginning them? I just wonder whether that might show up first.

There has been some discussion that living long-term with HIV might also contribute to lipoatrophy.

Is this your first regimen, or were you on other cocktails before this? If so, this progression could be a result of previous exposure to more damaging drugs, which I have read may continue even when the previous medications have been halted.

With lipo, there are few easy answers, I am afraid.

HUGS,

Mark

[Miss Philicia]

Is this your first regimen, or were you on other cocktails before this? If so, this progression could be a result of previous exposure to more damaging drugs, which I have read may continue even when the previous medications have been halted.

This is very important.  Lipoatrophy, as a cellular dysfunction, can take a while to present itself.  Kaletra and Truvada (especially the Truvada) is seen as a "friendly" combo for this stuff, and if one was on Zerit or a handful other other things previous to this regimen than I'd suspect that what this poster is seeing is simply a delayed metabolic dysfunction response to that.

How do I know this (aside from what I've read)?  Because this is exactly what happened with me, except I stayed on Kaletra and Truvada and my lipo eventually stabilized.  Generally the most one sees with that combo is some weight gain in terms of visceral fat (i.e. not on the surface under the skin, but buried deeper down) and that's from the Norvir component, not the other part.  In fact, studies show that Kaletra is less likely than even Sustiva to give one fat loss in the face/limbs.  Viread/tenofovir is definitely the safest of the NRTI's.

Nobody will ever guarantee that you are not getting lipo from the combo however -- anything is possible and not everything is known about this dysfunction, but it's not a very likely scenario especially if you've been on previous HIV med regimens.  From your wording, PLL, in terms of facial fillers "with more frequency" I would assume that is the case.

[PLL]

Mark,

Thanks for your response!  Yes my lipids have gone up some.  A part of me also agrees with that school of thought that living long term with HIV might contribute to lipoatrophy.  I have been on many cocktails throughout the years but have lasted the longest with this one. From what I recall.... You know how it is, the years start to blur sometimes especially after 18 years of this.   I am going to see my doc in a few weeks and see if I can switch to something else.  I heard that Atripla is really good and does not produce lipoatrophy given the manner in which the meds attack the virus?  Have you heard that before?  Any recommendations?  M  

[PLL]

Miss Philicia,

Thanks for your insight!

M

[Peter Staley]

PPL -- please reread Philicia's reply. which was well said.  You will most likely get NO benefit switching from your current regimen, which is considered one of the most lipo-friendly regimens right now (lipo-friendly = least likely to cause fat loss).

Switching to Atripla is actually only switching one of the 3 drugs you currently take.  You'd be swapping the Kaletra with Sustiva (Sustiva + Truvada = Atripla).  Sustiva is actually considered MORE likely to cause lipoatrophy (fat loss) than Kaletra.

It's your long history of prior meds that have probably caused any fat loss you've seen, NOT your current regimen.