Before beginning medication I lost about 10 kilos. I went into hospital with double pneumonia (Nocardia) and severe esophagal Cadiasis. Both were treated with antibiotics and antifungals successfully. At the same time I began a Sustiva/Truvada regimine which I have been following for about 11 months. I also not only gained back the 10 kilos lost, but have gained another 8 to 10 kilos extra (not overweight, always had been thin and now I'm simply near my ideal weight). Have a bit of belly fat and a nice facial fat structure. The question: what is the likelyhood of my losing facial fat on this regimine? Not much is ever said about Truvada as it seems to be rather new, and I'm wondering if on the long haul I might experience loss of facial mass (which, working in public, would not be helpful to me....). Thanks for your reply.

Facial lipoatrophy has been linked to antiretroviral therapy, but some medications are more likely to produce it. In particular, AZT (zidovudine, Retrovir) and d4T (stavudine, Zerit) are the worst offenders.

Studies have shown switching from either of these agents to Viread (in Truvada) leads to improvement of this problem. So Truvada is the least likely of the nucleoside combinations to cause this complication, but facial fat loss may still occur on this agent.

Thanks for posting and best of luck!