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Author Topic: Only 5 Weeks on Meds - Mild Lipo?  (Read 6755 times)

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Offline BKNYLivin

  • Member
  • Posts: 76
Only 5 Weeks on Meds - Mild Lipo?
« on: March 19, 2007, 04:36:27 PM »
OK, I haven't been diagnosed with Lipo, but my face is definitely changing. I noticed it after only about 2 weeks, but thought I was just being paranoid, 'coz this was my main issue with meds. But, my cheeks are definitely sunken(no, I haven't lost weight recently) and I'm developing noticeable laugh lines (never had them b4).
It's still mild, but I can see it and a friend pointed it out today. I'm surprised that this is happening so soon(tomorrow will be 5 weeks on Atripla) and I know I'm not seeing things or going crazy.
Is it worth getting a facial filler in the near future(say 2-3 months), if this trend continues? I read in another thread it might be a good idea to start early, or should I wait at least 6 months or so(assuming it doesn't get too bad).
Has anyone else had this happen so soon after starting meds? I know the virus on its own can also cause changes etc. and it's not normal aging - it wouldn't be so sudden.
I'd like to hear from others - especially if you've had a similar(or sudden) experience.
Remember it's not major, but it's my face and if it gets any worse I will get it fixed, so I'm not panicking(just really surprised).
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline Soolip

  • Member
  • Posts: 18
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #1 on: March 20, 2007, 12:34:08 AM »
Most lipo occurs with the first 2 months of starting certain meds (for me it was Zerit).

I could have had it worse. I was on this drug for only 2 years, and had progressed to an early stage 2. After about a year off Zerit, noticing that it had not progressed further, I decided to get treated with a permanent filler by a doctor here in Los Angeles. I'm very happy with the treatment, it looks and feels completely natural.

The "laugh lines", unfortunately, cannot be treated as easily. Botox and similar treatments will help, but they are not permanent.

Offline SouthSam7

  • Member
  • Posts: 428
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #2 on: March 20, 2007, 05:56:49 AM »
I thought it took months or years for lipo to show up.  Maybe I'm thinking of protease paunch.  Either way, the combo drug you are taking is not likely to cause lipo. 

I thought I had protease paunch but actually I quit recreational drugs when I started hiv meds, so I was just putting on a little fat.  Now I work out every day and look much better. 

Don't psych yourself out; I hope it's nothing.

Sam

Offline BKNYLivin

  • Member
  • Posts: 76
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #3 on: March 21, 2007, 12:30:14 PM »
Thanks for the replies. Well, if it is true that most Lipo occurs within the first 2 months or so, then I'm hoping this doesn't get too bad, but my face is definitely changing every day(slowly, but surely). Some kind of crease seems to be forming on my right cheek as well in the last couple of days, like a double laugh line or something.
I guess I'll see how the next few weeks go and then make an appointment for some kind of filler.
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline Soolip

  • Member
  • Posts: 18
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #4 on: March 22, 2007, 12:18:30 AM »
The first thing you need to do is talk to your doctor and see if he will change your regimen. Most people with HIV do not have to take meds that are known to cause lipo.

Second, do not rush out and get your face tinkered with. After switching meds, wait a few years. Many people with modest facial fat loss will gain some of it back.

Temporary fillers will cost you a lot of money. Sculptra is touted as lasting two years. People I know who have been treated with Sculptra say they start losing volume 6 months to a year after the last treatment. Like Botox, it's an expensive cycle. If money is no object, go for it.

Permanent fillers cost less in the long run -- but there is no reason for you to persue this avenue unless you have evidence of persisting, long-lasting lipo. I suffered with lipo for nearly 3 years, waiting until I was sure the condition had stabilized, before getting corrected with a permanent filler.

You could just be getting old... did I say that?

« Last Edit: March 22, 2007, 12:20:57 AM by Soolip »

Offline BKNYLivin

  • Member
  • Posts: 76
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #5 on: March 22, 2007, 04:16:42 AM »
Thanks Soolip. I won't be looking at anything permanent right now (who knows what meds I'll be on in the future) - Sculptra or another temporary filler will do just fine. I'll see how the next few weeks go(doc is on vacation anyway) and then maybe discuss switching. I don't think I'm just getting old - it wouldn't have been so sudden.
Anyway I have an appointment with a cosmetic surgeon later on today to discuss my options. 
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline suzieque

  • Member
  • Posts: 61
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #6 on: March 22, 2007, 07:25:35 AM »
HI.
 I can empathise, I have had many challenges with lipoatrophy and have changed meds (and stopped meds) several times as the result of this. On the positive side I can say that changes and breaks have halted and even reversed the lipoatrophy I had. The last time I stopped I got PCP though, so I would be careful of treatment interuptions without high CD4 count (and also seems you have just started too). It is SOOO difficult to be objective too! I have to say that while I definitely have had lipoatrophy,it was quite obvious, there have been just as many times where I have not but just am highly conscious and nervous about it. I am now on a solely PI based combo, Atazanavir, Saquinavir and Ritonavir booster and am doing well with no lipo problems on this. In my opinion it is worth checking with your doctor about possible med changes and seeing what happens (does it stop? Does the fat come back?) before opting for fillers ( I went 2 years ago and consulted with someone about New Fill, changed meds, fat came back, did not ever have to do it). Remember that while it is wonderful to know that these options (fillers) exist, and improve many peoples quality of life dramatically, they are not without their own potential problems and do need to be redone at some point.
                Best wishes to you whatever you decide,
                                     Suzie

PS. Don't be surprised of your doc does not recognise that you are beginning to have lipo, it took me ages to get my doc to see it! See if you can find someone objective to keep an eye on it for you, I ask my husband most days!

Offline SouthSam7

  • Member
  • Posts: 428
atripla lipo? I don't think so...
« Reply #7 on: March 22, 2007, 03:00:47 PM »
As I've said earlier, I don't think your meds are known to cause severe (if ANY) lipo.  It's usually Zerit or the protease inhibitors.  Anyone else agree?  Disagree? 

Sam

Offline allanq

  • Member
  • Posts: 689
  • still life with pills
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #8 on: March 22, 2007, 10:11:28 PM »
AZT, as well as Zerit, can cause lipodistrophy.
Top (Breakfast): Prezista, Norvir, Isentress, Zoloft (2), Glyburide (2), Aspirin
Bottom right (Dinner): Prezista, Norvir, Isentress
Bottom left (Bedtime): Sustiva, Trazodone (2), Lipitor, Septra (no longer taking this)
Center: Alprazolam (Xanax)
Not shown: various vitamins & supplements

Offline egello

  • Member
  • Posts: 899
  • cb
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #9 on: March 23, 2007, 01:14:25 AM »
what about Norvir, Rayataz or Truvada?

what is protease paunch?
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline BKNYLivin

  • Member
  • Posts: 76
Re: atripla lipo? I don't think so...
« Reply #10 on: March 23, 2007, 07:25:22 AM »
As I've said earlier, I don't think your meds are known to cause severe (if ANY) lipo.  It's usually Zerit or the protease inhibitors.  Anyone else agree?  Disagree? 

Sam
It is stated as a possible side effect and my doc did mention that it was a possibility B4 I started taking the meds. I'm sure it's not as severe as Zerit in terms of actually stages of Lipo, but it does happen. Also levels of certain meds (eg Sustiva) have been found to be higher in black people(apparently we absorb more of it, so that could be a contributing factor) and I bet that's not generally taken into consideration. I think most meds(HIV or otherwise) can probably affect people differently - we won't all have the same side effects and these meds are still relatively new.
I just thought it would have taken longer, but you live and you learn, which is what I like about this forum. The important thing is that there is something that can be done about it and I now have a plan of action

egello - I believe protease paunch is the big belly some people develop on meds 
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline BKNYLivin

  • Member
  • Posts: 76
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #11 on: March 23, 2007, 07:32:28 AM »
"Anti-HIV drug regimens containing Sustiva, Viread, and Emtriva can can cause increased fat levels (cholesterol and triglycerides) in the blood, abnormal body-shape changes (lipodystrophy; including increased fat around the abdomen, breasts, and back of the neck, as well as decreased fat in the face, arms, and legs), and diabetes. These side effects of anti-HIV drug therapy are reviewed in our lessons on Lipodystrophy, Facial Lipoatrophy, and Risks To Your Heart (Hyperlipidemia)."
http://www.aidsmeds.com/archive/Atripla_1577.shtml
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline suzieque

  • Member
  • Posts: 61
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #12 on: March 23, 2007, 08:26:30 AM »
 In my experience I did have lipoatrophy on Tenofovir (one of the elements of your atripla). At first my doctor said it had never been heard of and was not that drug, however a year later and he has seen it affect several people in this way. PI's generally cause fat gain ,not loss, however there are some examples of Ritonavir causing lipoatrophy, but through a different process ( not mitochondrial toxicity). My doc says he does not believe this and has never seen lipoatrophy on anyone on solely PI based regimes.So far so good for me ( again am on Saquinavir, Atazanavir and Ritonovir booster). You are right, all of our bodies respond differently to different things, however there are trends with each class of medicine. Anyone out there on any of the new drugs around (entry inhibitors and so on)? If so, how is it going?

Offline SouthSam7

  • Member
  • Posts: 428
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #13 on: March 23, 2007, 05:17:31 PM »
Suzie that's amazing.  I haven't heard much of a single class regimen.  I'm on Invirase and Norvir, too.

Keep us posted.

Sam

Offline Brackie

  • Member
  • Posts: 33
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #14 on: March 27, 2007, 09:39:56 AM »
Bknylivin, may I say that I completely see where you are coming from. Around the end of April last year I had sex with someone and the condom broke and I was top. Not knowing their sexual history, I did not want to take a risk so after a bit of consultation and decision making I decided to take a course of PEP. I had a 28 day course of Tenofovir and Lamivudine . I wrote on here informing people of my experience of the drugs and found a lot of encouragement and support.

However, after a week I noticed quite a thickcrease down the side of my face which appeared to come from a "laughter line" but was much thicker than you would normally expect. Probably not dissimilar to the one you mentioned you had discovered. My first thought was, oh its the drugs..this is affecting me. I was told that it wasn't possible and it simply doesn't happen in this period of time, let alone with these drugs. I finished the treatment anyways, despite finding out near the end that the guy I had slept with was HIV neg..but how was I to know right?

Anyway, I am now nearly a year down the line and my cheeks are quite hollow. The difference from where I was in May of Last year to know, I believe is quite large. This very evening I had dinner with a girlfriend I hadn't seen for 6 months...and nearing the end of the night she said to me, "You look like you have lost weight in your face..What Happened?" Needless to say I was very distraught inside that she had noticed, despite the last 6 months of all my friends saying there was no difference and that I was imagining it. That's the point, people who see you every day are unlikely to notice it but someone who hadn't seen me in 6 months clearly did. My weight has not changed in any other way..in fact it remained stable thoughout the course of PEP and ever since.

Anyway, I finally saw a plastic surgeon last week and he explained the benefits of Sculptra. He  also showed me before and after pics of several people and I must say I was impressed with his work. Contrary to what I thought was the generally accepted opinion that it is a short lived treatment, some people on this guys books had went for 4 years with no touch ups, so I guess it must depend on the individual.

Sorry for rambling, but I just wanted to say I totally empathise with you and understand you fears. The simple fact is that we do NOT know everything about these drugs and in my experience they DID effect my face even after only a month of use. I am so paranoid now, I don't know what to do. Yes the sculptra is an option, but I am also terrified of the complications that may arise from that and after jumping in with 2 feet for the PEP, I am afraid to do the same here. Until tonight, I had always wondered when the first day would come that someone would actually ask me if something was wrong and now they have. I am also thinking, well is this fat likely to ever come back? Or, is it gone forever? Moreover, will it keep going? Why on earth did my face keep getting thinner even after I stopped the treatment????? Secondly If I take the sculptra and the fat comes back, will I go from one extreme to another..Ie, having thin cheeks to over fat?

I am extremely depressed at the moment and the worse thing is I feel so annoyed with myself for panicking and taking the drugs in the first place. Yes I know they are life savers in one aspect but I just wish I had had more education about the side effects before I took them, in my particular circumstances.
« Last Edit: March 27, 2007, 09:48:21 AM by Brackie »

Offline BKNYLivin

  • Member
  • Posts: 76
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #15 on: March 28, 2007, 03:43:07 AM »
Suzie/Brackie, thanks for ur input.
Suzie - yeah, I'll be discussing possible changes with my doc next appointment(in about 2 weeks) and I have a close friend "monitoring my face". Don't particularly want to change meds right now, so I'll probably see if I can stick with Atripla for the next couple of months at least. Obviously, if it gets much worse I will be off it sooner rather than later. Looks like Scupltra will be the way for me, whether its in 3 weeks or 3 months, we'll see.
Thanks for your support.
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline Brackie

  • Member
  • Posts: 33
Re: Only 5 Weeks on Meds - Mild Lipo?
« Reply #16 on: April 09, 2007, 02:56:16 AM »
Suzie/Brackie, thanks for ur input.
Suzie - yeah, I'll be discussing possible changes with my doc next appointment(in about 2 weeks) and I have a close friend "monitoring my face". Don't particularly want to change meds right now, so I'll probably see if I can stick with Atripla for the next couple of months at least. Obviously, if it gets much worse I will be off it sooner rather than later. Looks like Scupltra will be the way for me, whether its in 3 weeks or 3 months, we'll see.
Thanks for your support.

Hi Bkny, Just wondered how things were going and whether you had decided to have the Scuptra treatment yet? Hope all is well.

 


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