Southern African HIV Clinicians Society

Medium-Term Complications Associated with Treatment with D4T and How to Manage them.

A 35 year old woman who was diagnosed HIV positive in 1998 when she presented with shingles on her left flank. In October 2004, her CD4 was 34 cells/mm3 and her viral load (VL) is >750,000 copies/ml She is started on regimen 3TC, D4T, NVP. Nine months later she complains of changes in her breast size, her stomach is larger, buttocks smaller and legs are thin with prominent veins. Question 1: What do you do now?

A.	She most likely has lipodystrophy so you wait for it to go away

B.	She most likely is experiencing lipodystrophy – you switch her regimen to AZT/DDI and Kaletra

C.	You check a viral load and creatinine and change the Stavudine to Tenofovir

D.	You change her regimen immediately to something that does not cause lipodystrophy such as AZT