Considering a Haart break.

[ryeguy]

Hello to all,

Well once again I am here to bitch about lipodystrophy. I have tried allmost everything, fasting, working out like crazy, changing my Ha art therapy, cardio every day, no cardio and then only weight training, then a combination of both, eating only protein, then eating a combination of everything, every diet every supplement but almost nothing really helps.The only thing which seems to milden the lypo is a combination of cardio and weight traing and to eat little fat. Still like most of you know the lypo just does not go away, even with a whole lot of discipline it seems only to slow down a bit.

My Dr. recommended a Ha art break, I am not sure if I want this because I remmember how crappy I felt before I started in 2001. With the meds I feel great but look like shit. I am not sure if I want to look great and feel like shit:-)) My numbers are about 780 helper and since 2001 Vl is undetectable.

I am 32 and have from the waist up a fairly athletic body.... OK the stomach could be a bit more defined but more than 4 hours a week on ab-training is just too much.!!! From the waist down I don't have a gram of fat on me and sometimes I just feel ashamed in public. In the Subway on my way to work I get a lot of strange glances from commuters. They all seem to look at me with a question mark, like something about me is just not right. Some glances are like 'hey buddy eat something cause you ain't got no legs! But nice upper body.... how the fuck did you accomplish that? The legs of a hungering marathon runner, and upper body of a moderate body builder.` Sometimes I feel like saying something but I am sure this would not help.

My doc says that a ha art break will stop the hypo for the duration of the break and after about 6 months fat will begin to return to the extremities. The longer the break the better it should be in my case for the lypo, but the longer the break the greater the risk of messing up my good numbers. He also did remind me that eventually I will have to start ha art again, and certainly the fat gains will be lost within 6 months.

Can anyone here share an experience with fat gain in a Ha art break or share with me how they felt throughout a ha art break, the duration of the break and the effect on there numbers. Thanks:-))

[ademas]

I haven't taken a HAART break, so I can't offer any first-hand experience there.
As I understand it (and I'm sure someone will correct me if I'm wrong), your numbers can fall quite quickly to pre-HAART levels (should you choose to take a break). 
Where were your numbers before HAART?

I can relate to the dilemma, ryeguy. 
I either carry more weight than I'm comfortable with (about 20 lbs.) to keep my face and legs looking healthy, or I drop 20 lbs. to feel better about the upper body, but then my legs become roadmaps and my face looks hollow, and people start asking if I feel okay.

[ryeguy]

Thakyou for your response. As I have been informed you are right about the number drop off I just hope it is not too rapid. I hope to be off meds for up too one year but of course I am not going to play any Russian Roulette! If my viral load gets to high or helper cell count drops below 250 I will start up on my meds again.

Before I started Ha art in 2001 my viral load was 47,000 and helper cell was 240. All internal organs were swollen and after suffering from a severe brain infection my Dr. and I decided it to be wise to start ha art. At that time he put me on a very rigorous com bi therapy with not 3 but rather 4 components. I attribute this to the relatively fast developed lypo which I have developed.

I here you with the leg issue brother!1 :-)

[blondbeauty]

And what about changing your combo instead of stopping HAART? Have you tried that. What meds are you taking? are you resistant to any meds?
http://www.thebody.com/confs/aids2006/wohl1.html?m166h
http://www.thebody.com/chat/lipoatrophy1105.html
Reply from Dr. Joel Gallant: Frank, the best thing you can do is to take medications that don't cause lipoatrophy, which is easy enough to do if you're starting therapy for the first time, without any drug resistance. I have lots of patients with lipoatrophy, but they're all people who've been on therapy since back in the 20th century. I'm not seeing NEW development of lipoatrophy anymore, because we now have better treatment options. Don't let the fear of lipoatrophy dissuade you from taking antiretroviral therapy if you need it!

[dtwpuck]

I was just going to suggest changing to something that doesn't cause lipo, but Dr Frank beat me to it, I see.

Anyway, I had a crix hump once.  It's gone now.  And, yes, it was one hell of a lot of hours on a bicycle, elliptical etc.  But, since I actually really like working out... I guess it was a good thing.

I've thought about taking a break before, but never really had the guts, so to speak.  I'm curious to know what others' experiences are.

[poet]

Ok, from someone who would not consider ever taking a HAART break, but did have to change meds. three times I think it was because of allergic reactions to certain meds, I seriously hope that you will, as you sound like you would, read up on this?  I haven't seen any data supporting even weekend breaks over time and, if we look at it logically, yes, you would perhaps go back to square one and undo the effects of lipodystrophy, but since you will want/need to be on meds, where would that get you?  The minute you got back on them, you would be right back where you are/were.  Hopefully someone will post in other approaches?  Best, Win

[blondbeauty]

Another answer contained in this same we website. Aidsmeds has an answer for every question.
http://www.aidsmeds.com/articles/1667_10955.shtml

[ryeguy]

Today is the second day of my meds-holiday and I feel great.

I would like to point out I have considered this with my Dr. and do not take this lightly I will also be going in for blood work 1 time a month and think this is the right answer for me and do not rec comend anyone else doing this without the support and advisement of a good hiv specialist. Thanks all for your input, I will keep you posted as to how I feel good or bad and how this turns out.

[Ihavehope]

Hey Rye

Thanks for keeping us posted. I am glad you are happy with your decision. Only you and your doctor know whats best for you. Can I ask you what meds you were on? Also did your doctor tell you in the future you will return to the same regimen or different one?

[blondbeauty]

Good luck. But if you return again to the same combo you will get lipo again with the only difference that your immune system will be weakened. Please, be careful and take care. 

[randym431]

Hi there
I take sustiva and epzicom and after almost a year I started getting all the weight back. I have a friend on meds since 1996 and he has severe loss in the face. His doc switched him to the latest, sustiva and truvada, 9 months ago. He doesnt live near me so I dont see him, but we talk a lot. I ask if he ever gained some weight back on his new meds and he said no. And he claims once you lost the fat cells, they dont come back. So he doesnt expect to gain any. He seems pretty up on all this, so just a caution that you may not get the weigh back, even with a med break. Just be careful, I know you are doing that already. And I know those public stares one gets and how you wonder what they are thinking. Just try to ignore them. Maybe you remind them of a movie star or someone famous. Or, you just might look rich. 

[ryeguy]

thanxx a lot :-) The next time I get a strange look I'll smile back and pretend I am Tom Cruise in the subway-:-))) LOL

My combo is truvada with viramune once a day. -and yes I can return to it. Weather the fat comes back or not will only be told with time;-) I will keep you all posted.