I am beginning my first regimin, Truvada, Reyataz, and Norvir. Of the three, Norvir has been shown to have consequences related to fat redistribution. I find a great deal regarding side effects of this drug but not much regarding side effects when used as a booster. Fat redistribution would destroy not only my career but my definition of life. Thanks, A dancer.

Hello Dancer,

HIV-associated fat redistribution syndrome is not yet completely understood. There are a number of factors involved in the process. The effect of various HIV drugs is still being elucidated. We do know for instance that thymidine analog drugs, such as D4T and AZT, are more likely to be associated with fat loss (lipoatrophy). You can read more about his in The Body's lipoatrophy resource center which can be easily accessed under "Quick Links" on The Body's homepage. The exact role of protease inhibitors in HIV fat redistribution syndrome is less clear, even thought the syndrome was first identified with this class of drugs ("Crix belly" for its association with Crixivan, "protease paunch," etc.) However, the exact mechanisms are still unclear and these effects are by no means universal.

Since this is your first HAART regimen and, as a dancer, you are obviously extremely concerned about certain potentially drug-related side effects, I would suggest you discuss these concerns with your HIV specialist. Depending on your resistance profile and other factors, you may be a candidate for a regimen that avoids both protease inhibitors and thymidine analog drugs. For instance, Atripla, which contains efavirenz, tenofovir and emtricitabine.

Good luck.

Dr. Bob