Question:

I have taken EFV, D4T, 3TC for 5 years, and now discovered ongoing breast enlargement. What do you think I should do for the moment, stop EFV, or the whole regimen, for it is so upsetting to take the current developement of this side effect.

Answer provided by:

Octavio Vallejo, M.D., MPH
Faculty, UCLA Pacific AIDS Education and Training Center

Your question is quite interesting because the regimen you are taking is more related to lipoatrophy (fat loss) and not fat accumulation. I wonder if you have been taking any medications such as testosterone or anabolic steroids for wasting (weight loss). These medication have also as a side effect breast enlargement. Finally, I will recommend to check with your doctor the possibility of switching 3TC and D4T for medications with more convenient schedule and same potency, in this case changing to a NRTI backbone that includes tenofovir and emtricitabine might help you to reduce the number of pills and reduce the amount of dosage to once a day. I will also recommend to ask your doctor about checking your glucose metabolism and off course exercise and nutritional counseling to reduce the amount of body fat in your body. I hope this information will help you to reduce these body shape changes.

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