Q and A

Question

What can I do about darkening of the skin and thinning of the limbs and face?

I am on Truvada and nevirapine for HIV, I am also on a preventetive antibiotic Septrin, because my CD4 count is below 200 (i.e 156). I was dignosed with TB but have since finished treatment for TB. My problem is that since I started treatment I developed changes in my body that might be noticed by those who knew me before. Changes include darkening of skin, especially face, thinning of face, arms and legs. Are these changes due to the medication I am taking? If yes, what can be done with the problem? Thank very much and keep on doing the good job you are doing for us.

Answer

Thank you for your question.

Darkening of the skin may be a result of low levels of vitamin D. I have replied to a similar question here. Hope you find the answer useful too.

As for the thinning of the face, legs, etc, this may be a condition called lipodystrophy. There is a very detailed information about it here.

Please note that taking the ARVs is still very important, as your CD4 count is still low. Your doctor may decide to make changes after you talk to him/her. It is important, however, that you do not interrupt or change medicines on your own.

88 comments

  1. Lisa Thorley

    Hi Margaret,

    Other than the issue with your skin, what’s slightly concerning is your CD4 count as it’s still low. What was your CD4 when you were diagnosed? Do you know what your viral load is?

    With regards to the darkening of the skin, zidovudine is known to cause skin darkening. Please see here: http://i-base.info/guides/3531

    You should ask your doctor if you can be switched to another ARV combination.

  2. Margaret

    Hi Dr. I’m taking Aluvia, lamivudine and zidovudine for two years now my skin become dark. My CD4 last year September was 77 on January this year 125 what can I do to improve my skin

  3. Lisa Thorley

    Hi DK,

    Please see the following link: http://i-base.info/qa/4643 The important thing is that you start medication and as soon as possible.

  4. Dk

    What happens if one’s cd4 count is below 7

  5. Roy Trevelion

    Hi Mpumie,

    If you have just been diagnosed this can be a difficult time. This is true for most of us who are HIV positive. But please see this link to info about if you’ve just found out.

    As it says, Even if you feel worried, frightened, upset or angry now, it will get easier. You will still be able do all the things you wanted to do before you learned that you were HIV positive.

    Have you started HIV treatment yet? Modern HIV meds are easier to take and they have fewer side effects than the early drugs. So if you’re having side effects now you can talk to your doctor about changing to other meds that will be easier for you to take.

    Here’s an Introduction to HIV treatment (called ART). There’s a lot of info in this guide about starting treatment.

    Please let us know how you get on. And if you have access to your CD4 count and viral load results, please tell us this too.

  6. Mpumie

    Hi I was diagnosed with HIV during November 2019. At first I wasn’t scared but now It seems like the journey is still going to be long and difficult for me. Acceptance and the treatment is reacting m scared of people I’m loosing weight. Yho.

  7. Roy Trevelion

    Hi Siphiwe,

    It’s important that you talk to your doctor about your meds. The standard adult dose for Aluvia is 2 x 250 mg tablets, twice a day. So it looks like you’re taking a double daily dose of Aluvia which is not recommended.

    Please check this quickly with your doctor.

    Treating HIV and TB can be complex. Your doctor should give you the best advice on this treatment.

    If you live in South Africa, the Treatment Action Campaign can give local support. Please see their contact page at this link.

  8. Siphiwe

    HI I just diagnosed with TB so they gave me TB tablets with I must take 4 in the morning and the HIV tablet I’m suppose to take 2 in the morning and 2 at night but they say I must take 4 ALUVIA 200mg/50mg in the morning and 4 ALUVIA 200mg/50mg at night and I’m feeling deezy vomiting and my stomach is running;is it possible?

  9. Lisa Thorley

    Hi Zaza,

    Durobac is an antibiotic, please see here for more info: http://home.intekom.com/pharm/pharment/durobac.html Orally means that you swollow the tablets.

  10. Zaza

    Hi. I’ve been given durobac. I’m not sure which time of the day I should be taking them. It says in the label take 2 once a day orally and I don’t what this means.

    Please help

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