Dear Doctor,

I come from Zambia Africa and i find your website very useful. I have been on medication for a year now. I take Stuvidine, lamivudine and nevirapine but i have noticed that i am loosing a lot of weight from my butt and legs. I would like to change my treatment regimen, could you kindly advise which combination would have less side effects because i really dont want to lose my figure. Its kinda depressing. Please help. Thanks. Charity

Hello Charity,

Lipoatrophy (fat loss in the extremities, buttocks and face) is most often associated with HIV drugs called thymidine analogues. These include D4T (stavudine) and AZT (zidovudine, Retrovir, Combivir, Trizivir). Consequently, I would advise avoiding these agents. You can learn much more about lipoatrophy (fat loss) by reviewing the information in The Body's lipoatrophy resource center that can be easily accessed under the "Quick Links" section of The Body's homepage.

I'm not sure which HIV drugs are currently available in Zambia. Depending on what your HIV drug resistance profile is, one potential option would be efavirenz (Sustiva) + emtricitabine (Emtriva) + tenofovir (Viread). This combination has been combined into a single pill called Atripla, which can be taken just once per day. It's a common first-line HAART (highly active antiretroviral therapy) combination in the U.S. Talk to your HIV specialist about what would be your best option while avoiding D4T and AZT.

Good luck.

Dr. Bob