Can you be more specific about what you mean by "lipodystrophy"? It's an old term that encompasses both lipoatrophy (subcutaneous fat loss) and lipohypertrophy with an abnormal distribution (visceral, dorsocervical, neck, etc.) Both should be distinguished from standard body weight increase, where fat is increasing in the usual places.
The current regimen would not cause lipoatrophy--that was the result of old NRTIs that we don't use anymore. Currently used drugs aren't typically associated with abnormal fat distribution either. As for weight gain, it's frankly not clear that any ARV drug actually causes weight gain (other than by making you healthier), and there's little evidence that regimen changes make any difference. There may be reasons to change this person's regimen (metabolic complications, drug interactions, food requirements, etc.), but I'm not sure lipoatrophy or weight gain apply here.
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Joel Gallant, MD, MPH
Santa Fe, NM
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Original Message:
Sent: 08-06-2024 10:11
From: David Farber
Subject: Lipodystrophy
We inherited a patient that is on Juluca + Prezcobix that has developed quite a bit of Lipodystrophy. Of course they would like to change regimens. Undetected <20 on and off for over 2 years, highest viral load was 35. Genotype showed low level resistance to ATV/r. That's all I can find, we inherited, old records. etc.. you know the drill. Thoughts?
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David Farber
Rapid City SD
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