Hello Dr.Henry My name is Jose H. i used to be one of your patients when i first got diagnosed in Minnesota. since then i have been on several regimens. the most recent being Retrovir,Sustiva, and Truvada. I have developed facial lypoatrophy and desperately want to look the way i did before.I don't have money for cosmetic surgery so I stopped taking the Retrovir to see if any improvement occurs.what can you recomend to me to reverse these effects or make it less noticeable? E-mail me at joeyrican@msn.com thank you hope to hear from you soon.

I don't recommend stopping one of your four drugs which could lead to failure of your entire regimen unless you have no history of any drug resistance. More often I would discuss a switch from AZT to perhaps abacavir or other meds (often Truvada + Sustiva is enough). There is an ACTG study soon to open looking at use of uridine supplements for fat loss (too early to recommend that approach without more data). Plastic surgery is expensive but some patients qualify for reduced rates of the substance (such as Scuptra) that is injected which helps out some. Treatment of lipoatrophy is presently a very frustrating topic. Avoiding or switching off HIV drugs that are most linked to the condition is presently a key component of efforts to minimize the problem. Reversal can be very slow to observe. KH