I have been treated with Combivir + Sustiva 600 almost inmediately after testing positive for HIV in 2004. During these 4 years my viral load went from 135000 to undetactable and CD4 from 500 to 850. The problem is that my weight went from 175 pounds to 153 with butt, leg, arms and face skinnier than ever plus a not-so-cute belly and love handles. I'm 33 years old and I try to excersise regularly, but i cant seem to gain my weight back or get rid of fat accumulation around my waist. Any suggestions? Monchi

The first question is whether you need to be on antiretroviral treatment at all based on normal CD4+ lymphocyte count and clear evidence of medication related side effects.

At the very least, switching the AZT for Viread would help prevent further body shape changes. You should have testosterone levels checked and may benefit from anabolic steroids based on what sounds like significant muscle loss as well as fat loss.

For the facial lipoatrophy, treatment with a facial filler like Radiesse and Sculptra is an option which can help with facial appearance.

Thanks for posting and best of luck!