hello, and thank you in advance. are there treatments for lypodystrophy? and are there certain hiv drugs that are causing this condition? my brother has been hiv positive for 20 years; and he is really suffering from weight gain in stomach, and posterior sides. conversely, he is loosing fat in his face. cheeks sunken. can liposuction help? what tests can be run to determine lipid or adipose levels? he is really getting frustrated with self image, close not fitting, etc. that is along with all of the other ill effects of his condition. thank you again linda

Fat loss in the setting of HIV infection can be related to aging, low CD4 counts, time with HIV, genetics, and other non-drug factors as well as to certain HIV meds (mainly the thymidine analogs stavudine/D4T and zidovudine/AZT). If possible switching off any offending meds to a suitable alternative as early as possible is the best option. There is at present no generally effective and safe treatment for established fat loss. Diet and exercise are usually more helpful for fat gain conditions than fat loss conditions. The situation is frustrating at present-there are a number of investigational drugs being looked at for treatment of fat loss and the condition is getting lots of attention but the fact remains that many patients will remain frustrated for the time being. KH