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Facial wasting before treatment

Aug 2, 2009

Hello Dr Pierone,

I have been dignosed HIV positive just 3 week ago, I have been loosing weigh for a few months, that made me decide to have my blood tested for HIV. My CD4 count is 257 and VL 6700, I have been told I must start treatment. My concern is that with treatment my face will go even thiner than it has gone so far. I have been losing weight all over, of course, but it is very noticiable in my face, I have read that normally facial lipoartrophy is due to tratment, but it can also be due to HIV itself. If the treatment reduces the VL, would it also revert the facial wasting? or could Atripla make my facial wasting even worse? I am 47 yo. and a few months ago I had radieese injected on my face because I though that my wasting was just a sign of age, but even so now just a few months later it is looking very thin and showing hollow cheeks.

Thank you



Response from Dr. Pierone

Hello and thanks for posting.

Some people (with or without HIV) have a thin face that gets thinner with any stress or weight loss.

There is really no way to predict if your facial appearance will improve or worsen now that you are on antiretroviral treatment. Atripla is not known for worsening facial lipoatrophy, but it sometimes can. The benefit of Radiesse tends to fade as the filler is broken down and reabsorbed, so all else being equal, chances are the facial thinning will probably come back and more treatment may be necessary.

Good luck!

Losing fat in extremities
Fat Gain with Sustiva

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