I have been HIV+ since 1989 but only have been taking medications since 1998 with a three year "off" period when I couldn't afford to take them. I started taking a new regimen in 2003 and had to change because my cd4 count was dropping and my VL rising. My Doctor now has me on a regimen of tenofivir, combivir and atazanivir. I have developed some lumps under my skin in the rib area! Any idea what they could be? I also have had a swollen neck (above the collar bone and between the base of the neck). My Doctor doesn't seemed too worried and says it is stress , but it has been swollen continuously for over six months! It sometimes swells up like a tennis ball but at other time is only egg sized! Should I be worried/ Many Thanks, Charles

Charles-

Thank you for your post.

I have a couple of comments. First off, if you're taking tenofovir with atazanavir (Combivir noted), it's better that you are receiving ritonavir with your combination. The reason for this is that tenofovir significantly lowers atazanavir levels-- this effect is offset by using ritonavir boosting. Without the ritonavir, the lower taz levels could but you at increased risk of premature treatment failure.

Now as to your body composition changes, the lumps under your skin sound like benign lipomas (non-malignant fatty tumors). These are actually pretty common in the general population, but are probably somewhat more common among persons with HIV. As for your neck, I have more difficulty in diagnosis-- the possibilities are several, ranging from muscle spasm, to fat accumulation. I'd keep an eye on the neck issue-- keep your doctor informed of any changes in the symptoms. Sorry that I can't be more specific, but it's challenging to diagnose these things from the net.

Good luck, stay in touch. BY