POZ Community Forums
Meds, Mind, Body & Benefits => Lipodystrophy & Metabolic Problems => Topic started by: dearestgrandson on March 27, 2009, 01:40:47 pm
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I was wondering if anyone had any projections on what effect the decreased usage of Norvir would have on the total, overall, incidence and severity of lipoatrophy, lipodystrophy, and/or metabolic syndromes.
I know full dose Norvir is rarely used anymore, but low dose Norvir is the very basis of most protease inhibitor therapies. Without Norvir most of the protease inhibitors today would not be able to work effectively, or much higher doses would need to be taken in order to get blood levels high enough to inhibit HIV replication.
However, even these small doses have profound effects on lipids. There have been studies in both HIV positive and HIV negative volunteers that have shown that even small doses of Norvir, without an accompanying protease inhibitor still produces large increases in lipid levels. Some studies try to demonstrate the effect a Norvir boosted protease inhibitor regimen has on lipids. So they start with just the small dose of Norvir for 2 or more weeks, then introduce the protease inhibitor to see how much more of an increase is seen. And for the most part, it often isn't very much.
So when Norvir does become obsolete, because one day it will, what degree of severity or percentage do you think the overall lipoatrophy, lipodystrophy, and/or metabolic syndromes will decrease?
I predict a decrease of about 50% decrease in metabolic syndromes, and I predict the degree of severity of lipoatrophy and lipodystrophy will decrease about 25%.
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So when Norvir does become obsolete, because one day it will, what degree of severity or percentage do you think the overall lipoatrophy, lipodystrophy, and/or metabolic syndromes will decrease?
I predict a decrease of about 50% decrease in metabolic syndromes, and I predict the degree of severity of lipoatrophy and lipodystrophy will decrease about 25%.
Idle speculation of course, so who knows. I've been on a Novir booster of some sort now for 8 or 9 years, though previous to that somehow I managed to escape every being on a full dose Norvir regimen. I'm hopefully going on the clinical trial of GS-9350 in a few months so perhaps that will allow my elevated lipids to improve. That said, in comparison to many with a similar length of time on Norvir, my lipid panel isn't that shabby. Elevated in the context of what is "normal" but not warranting more than daily fish oil supplements.
last labs: triglycerides = 161, HDL = 31, LDL = 72, total cholesterol = 135
At any rate I was experiencing lipo previous to any use of Norvir, pre-2001 so I have trouble drawing much of a conclusion to all this.
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I am really just talking about overall incidence and severity. This is obvious speculation and I would have no way of knowing for sure. But from what I have read, even small doses of Norvir cause large increases in lipid levels and other measurements of metabolic health.
Obviously Norvir is not implicated in lipoatrophy/dystrophy if someone is not taking it.
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Uh, OK fine. Not sure what the point of this is.
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I suffered lipo long before I started to use a Norvir boost. I started meds with Atripla and switched to Reyataz. A lot of people told me I was looking sucked up. I think the Sustiva help strip whatever fat I had left. At this point the lipoatrophy has seemed to stop. There is a pocket in my right check but it hasn't gotten any deeper. It hasn't filled in either