I have been on therapy for 10 years, nine of which was on Zerit, Ziagen and Viramune. No problems until I developed lypoatrophy a couple years back and lost all the fat in my butt, legs and much in my face. I FINALLY got my doctor to say, "uh yeah, one of those meds is a culprit"... We switched my to Truvada and Viramune about 8 months back. Still great and undetectable... but it absolutely hurts to sit down and my legs are WAY thin. Not a great look when you are 6'5".

I can't tell if this fat loss has stopped with the change to Truvada or not... just very hard to tell. I have done a couple rounds of Sculptra and that helps, but only on my face. I am pretty much just happy to be alive and doing well, but would LOVE any update on possible ways I can help reverse the years of fat loss. Is there a specific diet change that can help if the actual fat loss has stopped (one that won't give me a heart attack in the process!) Thanks! John

There is no therapy that can be endorsed that is safe and effective for reversal of severe generalized lipoatrophy. Fat gain can be slow after switching off thymidine analogues. In severe cases the fat loss appears to include loss of fat cells in the region so there is no substrate to rebuild fat with. No diet or drug treatment has been shown to be generally effective and safe in HIV-treatment related lipoatrophy. Nucleomax (uridine supplement) is being studied for the treatment of thymidine related fat loss. Numerous anti-diabetic drug have been studied with generally underwhelming results. Switching off offending drugs is the key manuver to minimize the problem when alternative drugs are available. Current situation is frustrating. KH