POZ Community Forums
Main Forums => Pre-HAART Long-Term Survivors => Topic started by: aztecan on April 20, 2007, 07:52:41 pm
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OK, I should probably post this in the treatment thread, but I would rather post it here.
I have been researching the various meds to which I could switch. My goal is to avoid worsening lipodystrophy, specifically the lipohypertrophy.
If it weren't for that, I wouldn't switch because these meds have served me well for more than a decade.
That said, the only meds I can find that don't include the caveat about lipodystrophy are the NNRTIs and Reyataz (Atazanavir).
While the Reyataz doesn't sound too bad, the NNRTIs don't sound very nice. Or course, I could be reading more into their descriptions than is really there. I know people who take them and are doing well. I also know some who took them and became psychotic (sustiva).
My current regimen is AZT, 3TC (Epivir) and Crixivan, which is a regimen I'm sure at least some of you are familiar with.
So, anyone have any advice?
HUGS,
Mark
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Mark,
If you are afraid of psychological side effects, you might consider Viramune, instead of Sustiva. Also, from what I've read, Viread is less associated with lipodystrophy than other NRTI's. I notice from Joe's entry in the "Introduce Yourself" thread that he is on Viramune and Truvada, and that combo is working for him. Viramune is also less likely than Sustiva to cause an increase in cholesterol.
Just something to consider.
Allan
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The progression stopped for me--even improved a bit--as soon as I stopped PI's (particularly Crixivan & Norvir).
I've been on Sustiva & Combivir for years now.
I just wish I'd been able to get off the PI's before the damage was done.
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From what my doc told me, there is no guarantee that once one stops meds that might be the culprit in lipo problems that the progression will stop or reverse. In fact, most if not all AIDS meds have the lipo warning associated with them. Whether that's to stop lawsuits, or whether ALL AIDS drugs have to the potential to cause lipo, we may never know. I do know that in my case, all my docs do not want me to stop taking PIs because they are part of the drug combos that fight AIDS. It's better to have lost the fat, then to have lost my life. The only thing one can do is switch to drugs that offer a better chance of avoiding the problem, while at the same time getting the undetectable viral load.
My lipo problems started on the combination of Fortovase, Epivir, Zerit, and Videx. I switched to Reyataz, Norvir, Viramune, and Epzicom combination . . . which of course did not help any in eliminating the lipo - and I still experience it - especially in my butt. I have to continue to take Epivir because of the 'mutation' - so even though Epivir might also be attributed to lipo, I can't stop taking that one.
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Mark,
You asked for advice and I will give you what I would do in your position.
WAIT until the new class of drugs come out this year, as they are supposed to be like magic for us LTS. I really know nothing about them, but my Doctor is holding off until then in the hopes that we can start a whole new approach to this HAART thingy.
I guess the new drugs are a whole new class and have not been used in the past, so while you would once again enter the guinea pig state if mind, there is every hope that they do what the tests are showing, and that is huge efficacy for us, specifically.
Love,
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Mark,
Tibotec is soon to start clinical trials of a new medication for lipoatrophy- primarily directed at visceral fat deposition. It is a medication that is supposed to stimulate your production of human growth hormone, without all the negative side effects of HGH supplements. I don't know the name of the study just yet. I only found out about it recently.
I don't know if there will be an investigational site anywhere near you, but it might be worth keeping an eye out for it. I'll let you know when I find out more.
-Whiz
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Mark,
I think I agree with Tim, hang on if you can for just a bit, and let's see what comes along. I am on the same combo as Joe, Viramune and Truvada. It is working well for me, but I firmly believe Truvada is the culprit in much of my gastro-related issues.
Wouldn't it be great to just take a combo that had NO side effects??? My main heart medication, Coreg, is a wonderful drug that makes my heart pump better and more efficiently, and I can't tell that it has any side effects. If only I could be so lucky with HIV meds.....
hugs,
Alan
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Well, even though I hold hope with these new meds coming out you still can't predict what you'll find in terms of lipo with them in five years.
As far as Truvado and gastro, I'm on it and Pancrecarb tames the flatulence.
Otherwise as I've stated before, fuzeon and prezista as a combo seem to have no side effects, but most of you don't want to approach an injectable for that trade off. Understandable, and I'd be lying if I said that I'm not considering switching to one of these new meds coming out at some point. I just don't think I will immediately if I do not need to, preferring to wait another year and see what others say about side effects. I'll let others be the guinea pigs for now.
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Hi Mark,
I think you've already done your homework as far as options with currently available meds go. I seem to recall that you did not do well with Norvir boosting in the past. If that's the case, then unboosted Reyataz (400 mg/day) might be an option if you do not want to go the NNRTI route. You could still combine this with the Combivir, or you could switch the NRTIs to Epzicom (abacavir/3TC). Unfortunately, if you cannot do Norvir boosting with Reyataz, you cannot combine this with Truvada, so that narrows the option somewhat.
If you've never had any problems with resistance, then thinking of a switch now to curtail further side effects is a reasonable option. The newer drugs closer to the finish line would still be there in case you need to go this route down the road.
Gerry