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Ask the Experts about Facial Wasting
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Should I restart HIV meds for lipoatrophy?
Dec 12, 2008

Dr. Pierone,

I recently was diagnosed with diabetes and I have been HIV+ for 12 years. This past March my doctor decided to take me off my medications(Tcells over 1000 and viral load less than 750). Last year, I started to notice that my face was sinking. This past summer my mother told me I look sick. It hurts my feelings and I was wondering how soon I can start treatment? This issue starting to affect me emotionally and I started to seclude in my apartment afraid that someone will laugh at me. Please help me....

Sincerely yours,

Luis

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   Response from Dr. Pierone

It sounds like you have HIV-related facial lipoatrophy which is a complication of some of the HIV medications, especially thymidine analogues like AZT (zidovudine, Retrovir, Combivir, Trizivir) and d4T (stavudine, Zerit).

Treatment with facial fillers like PMMA, Radiesse, and Sculptra will reverse the appearance of the sunken face and would certainly be appropriated. If you do restart HIV treatment it would be wise to steer clear of the medications that promote lipoatrophy.

I hope this information helps and best of luck!



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