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Author Topic: Isentress and accelerated Lipoatrophy  (Read 3428 times)

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Offline razzmaniac

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Isentress and accelerated Lipoatrophy
« on: May 31, 2010, 08:18:59 AM »
In no way am i depressed or anxiety over anything because its just something I have to cover and live with. As long as my face is normal again from SCULPTRA (amazing stuff), im fine. . HA. . .but its amazing how the medications for HIV can save your life but in turn destroy your body to look unlike nothing anyone has ever seen. Its our scarlet letter forever. 
I have been on meds for about 14 years now. Started on the usual ACT, then to PI trial, then switched to alot of others including Videx and Combivir then ultimately to Atripla for a few years. I started noticing lipoatrophy so doc told me that Isentress effects a different part of the RNA so should not be as toxic so i started with Isentress and Truvada. Well in a matter of a few weeks I could basically watch the lipoatrophy accellerate. My legs and feet are now so destroyed with that that I can no longer wear shorts. (obviously). Thank God i love winter and play winter sports because summer time always brings the reality check of my condition. I can not go to beaches, pool parties, boating with friends, etc. I cant even do the extreme mountains sports i so love with people who do not know I am poz because shorts are required. I have been getting SCULPTRA injections so i "look" very normal and great in the face.
Has anyone else experienced the acceleration when the switch??

Online Miss Philicia

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Re: Isentress and accelerated Lipoatrophy
« Reply #1 on: May 31, 2010, 11:03:18 AM »
IMO lipo isn't an instant response to a medication.  As a cellular metabolic dysfunction it can take a while to show up, so my suspicion is that this isn't from Isentress but from a medication you too previous to that one.  For example, though I went on ddi (Videx) in 1993 it took four years for lipo to begin showing up.  It was subtle at first but reached full fruition by 2001, so that's a span of 8 years.  I can't recall what year I halted the medication, but that's the one that's suspected as playing the major part in lipoatrophy, along with d4T (Zerit) which I was also on for a good spell (though can't remember the exact duration) but would have been from mid-'94 until probably '97.
« Last Edit: May 31, 2010, 11:04:57 AM by Miss Philicia »
"I’ve slept with enough men to know that I’m not gay"

Offline mecch

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Re: Isentress and accelerated Lipoatrophy
« Reply #2 on: May 31, 2010, 06:38:27 PM »
Alarming news.

It does not fit what we usually hear for good medicine and research.  Are you sure you see accelerated Lipo within such a short time? 

Anyway, bravo for making it for so many years and keeping active and fit. I hope you find a solution soon and please report some more.

Welcome to the forum.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline aztecan

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Re: Isentress and accelerated Lipoatrophy
« Reply #3 on: May 31, 2010, 10:44:35 PM »
Hey Razz,

I have never heard of Isentress accelerating lipoatropy. I think it is more likely this change was a result of damage done by the earlier meds.

My lipoatrophy developed over time, and it was indeed progressive. I have seen no acceleration after switching to Isentress/Truvada.

My lipohypertrophy seemed to develop more quickly, but that may just have been my perception or it may be a result of a weight gain when I quit smoking.

How are you lipids? That is a another aspect of the meds, especially the PI, but in lesser degree also the nukes and non-nukes, that is more troubling because it can be life threatening.

As far as not wearing shorts, etc., I think you are perhaps being a bit overly sensitive. I also felt that way for a long time, until I started seeing people who are HIV -  whose legs were as skinny as mine.

I exercised regularly and people thought I was purposely watching my carb intake so I could look more "cut."

Now, I really don't care what they think. I have a buffalo hump, crix belly, horsecollar neck and chipmunk cheeks.

I still get naked at the hot springs, still wear shorts at the gym and still swim in a public pool.

We must accept the things we cannot change at times, regardless of how much we might want things to be different.

I hope you are still doing well.

HUGS,

Mark


"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Tempeboy

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Re: Isentress and accelerated Lipoatrophy
« Reply #4 on: June 01, 2010, 03:04:13 AM »
Hey Razz,

Isentress is not usually associated with lipoatrophy. 

It is more likely that you have experienced weight loss from your combo switch making your previuos lipo now more noticable.

Glad that your face is fab!

take care
Roughly roundabout somewhere in the eighteenth or nineteenth century, Sodomite begat Homosexual out of moral, medical and legal models, bequeathing him Identity, who inbred with Nuclear Family and Industrialism to spawn Homophobia.

Dean Kiley

Offline razzmaniac

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Re: Isentress and accelerated Lipoatrophy
« Reply #5 on: June 01, 2010, 07:40:01 AM »
Aztecan . . .God bless you, that made me smile. . . as far as lipids, i go to the doctor every 3 months and always closely watch all my CBCs and stuff. . .everything is always normal. I watch my diet as I have even before the lipo situation.
The more i think about it and read about it, because you lose a certain amount thats slightly noticeable, and then anything else after that makes it look like it was a drastic accelleration.
I read in a study in 2007 from CROI that in Canada or France, they accidentally discovered that Sustiva shows up to a 50% (dont know the wording or # exactly off the top of my head) higher chance of causeing Lipo. That there is a massive amount of absorbtion into the subcutaneous fat cells. This is coming from a CROI publication. I even had to bring the print out to my doctor. I think alot of doctors are afraid to admit this because Atripla is suppossed to be the ONE pill save all. The reason I bring this up is because that was what I was taking for a few years and right before that, I was on Sustiva, Combivir and something else.
A few years ago I even tried that Nucleomaxx for a year. . .that actually seemed to help and looked like it was reversing as the lipo was becoming more noticeable. . . .but that gave me such gastrointestinal problems and has 3 different alternative sweetners that are no longer legal to use in the USA. . .HAHAHAHA. . .go figure.

Offline mecch

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Re: Isentress and accelerated Lipoatrophy
« Reply #6 on: June 05, 2010, 06:30:58 AM »
Gee it would kind if you could locate that paper and provide a link, here. thanks.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline veritas

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Re: Isentress and accelerated Lipoatrophy
« Reply #7 on: June 05, 2010, 09:14:36 AM »

mecch,

Here you go, from AIDSmeds:

http://www.aidsmeds.com/articles/1961_11394.shtml

It was not the sustiva alone. It depends on what you combine it with.

v

Offline veritas

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Re: Isentress and accelerated Lipoatrophy
« Reply #8 on: June 05, 2010, 09:23:49 AM »

razz,

Isentress and truvada have the least risk of metabolic side effects:

http://www.thebody.com/Forums/AIDS/FacialWasting/Q205418.html

v

Offline Inchlingblue

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Re: Isentress and accelerated Lipoatrophy
« Reply #9 on: June 05, 2010, 10:56:16 AM »
« Last Edit: June 05, 2010, 10:57:53 AM by Inchlingblue »

Offline Billy B

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Re: Isentress and accelerated Lipoatrophy
« Reply #10 on: June 05, 2010, 11:22:11 AM »
razz,

Isentress and truvada have the least risk of metabolic side effects:

http://www.thebody.com/Forums/AIDS/FacialWasting/Q205418.html

v

This is the exact quote my IDS used when I switched from Atripla.
Billy B
VL 4420 CD4 340 CD4% 24   3/15/10 Started I&T
VL  UD   CD4 340 CD4% 26.5 05/13/10
VL  UD   CD4 360 CD4% 27.1 08/3/10
VL  UD   CD4 310 CD4% 28.4 11/22/10
VL  UD   CD4 420 CD4% 27.9 02/11/11
VL  UD   CD4 370 CD4% 26.4 06/08/11
VL  UD   CD4 360 CD4% 27.7 09/23/11
VL  UD   CD4 370 CD4% 28.3 01/20/12
VL  UD   CD4 430 CD4% 28.8 05/11/12
VL  UD   CD4 370 CD4% 28.1 09/07/12
VL  UD   CD4 390 CD4% 32.3 03/14/13

Offline mecch

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  • red pill? or blue pill?
Re: Isentress and accelerated Lipoatrophy
« Reply #11 on: June 05, 2010, 01:10:55 PM »
I guess I should be concerned about lipoatrophy but my ID says its not to worry about.  I notice fat all over my torso, I'm much meatier than ever in my life - but actually I was never meaty so I was kind of enjoying this!  This would be potential lipodystrophy, correct?  However the ID says its more likely age and lifestyle.

Hmmmmmm
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Inchlingblue

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Re: Isentress and accelerated Lipoatrophy
« Reply #12 on: June 05, 2010, 01:29:51 PM »
I guess I should be concerned about lipoatrophy but my ID says its not to worry about.  I notice fat all over my torso, I'm much meatier than ever in my life - but actually I was never meaty so I was kind of enjoying this!  This would be potential lipodystrophy, correct?  However the ID says its more likely age and lifestyle.

Hmmmmmm

Lipoatrophy (which is a sub category of lipodystrophy), only refers to fat loss, something that many with HIV experience in the arms and legs and butt and also the face—all to varying degrees. I think, based on personal experience and anecdotal evidence, that it can happen partly from HIV itself and also from some of the medications. There are some medications, especially the ones classified as "thymidine analogs," which no question make it much worse. These are not used much in the developed world anymore.

I also think, based on anecdotal evidence as well as on a few studies, that exercise, especially a combination of both aerobic and anaerobic, can help to minimize it.  

Most of the studies looking at lipoatrophy (including the one cited above I believe) only looked at arms, legs, trunk and butt but not the face.

Gaining trunk fat would not technically be lipoatrophy but rather part of lipodystrophy. I think it's harder to pinpoint how much of it is due to HIV meds. I know that I've always had a 29 inch waist (since I was 18) and after starting meds my waist has definitely increased for the first time in my life, to about 31. It's not a big deal and might be due to normal aging, it's just weird that it happened after starting meds. Part of it is just healthy fat gain from the body recovering after starting meds but at some point it can become excessive. After long term use of some of the early meds some people developed large amounts of deep or "visceral" fat in the belly, which is fat located within one's internal organs. This is not the same as having heavy subcutaneous fat, just under the skin.

« Last Edit: June 05, 2010, 02:03:52 PM by Inchlingblue »

Offline aztecan

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Re: Isentress and accelerated Lipoatrophy
« Reply #13 on: June 05, 2010, 02:28:20 PM »
Gaining trunk fat would not technically be lipoatrophy but rather part of lipodystrophy. I think it's harder to pinpoint how much of it is due to HIV meds. I know that I've always had a 29 inch waist (since I was 18) and after starting meds my waist has definitely increased for the first time in my life, to about 31. It's not a big deal and might be due to normal aging, it's just weird that it happened after starting meds. Part of it is just healthy fat gain from the body recovering after starting meds but at some point it can become excessive. After long term use of some of the early meds some people developed large amounts of deep or "visceral" fat in the belly, which is fat located within one's internal organs. This is not the same as having heavy subcutaneous fat, just under the skin.

The condition you describe is called lipohypertrophy. I know, I have it. You can actually have both types of lipodystrophy at the same time, or one without the other.

The problems with it come when the visceral fat surrounding your internal organs starts to infiltrate some of them, such as the liver.

I was diagnosed with non-alcoholic steato hepatitis (NASH). which basically means having a liver that is enlarged and has fat infiltrating it. It can sometimes progress to cirrhosis, but not always. Mine seems to have reduced since I switched meds and changed to a low-fat diet.

Many of us have hepatic steatosis, which is "fatty liver" and a precursor to NASH.  This could be caused by the meds, lifestyle issues, such as a high-fat diet, or any combination thereof.

I am afraid more of us will be running into this issue.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline xman

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Re: Isentress and accelerated Lipoatrophy
« Reply #14 on: June 06, 2010, 05:45:06 PM »
mecch,

Here you go, from AIDSmeds:

http://www.aidsmeds.com/articles/1961_11394.shtml

It was not the sustiva alone. It depends on what you combine it with.

v

If you read carefully the majority of patients in the study took also older regimens and not Kaletra and Sustiva alone. Their drug history impacted the results of the overall study. It didn't tell very much about the risks of Kaletra or Sustiva in developing lipo.
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