Dear Physicians, I was diagnosed positive in 1991. I am only recently noticing changes in my body fat distribution on my legs and arms. My legs have bumpy areas and the veins in my arms and legs are much more apparent. I have minimal changes in my face at this time. I am on Combivir and I have no setectable Viral load and my counts are in the high 700's. Could you tell me what medications I should consider to stop and reverse these changes? Please Help before the depresssion sets in.

Ask your doctor to work through the process with you. You will want to check on some things that could be treatable, like hypogonadism. You can also check to see if insulin resistance is a problem and if an oral antidiabetic, such as rosiglitazone, is a reasonble option for you.

In the non-medication arena, you should check your risk factors for fat changes and work on those, which include things like inactivity, smoking, alcohol, and diet. A mild/moderate activity routine may help to maintain or help to normalize lipid metabolism. A carbohydrate-counting diet (this is also called a diabetic diet) could be used to reduce the effects of insulin resistance (keep in mind that a "diabetic diet" is not just for people with frank diabetes). Smoking is a big one and will be important to address if you are serious about stopping and reversing fat alterations.

Best wishes!