Hi, I am a 25 yo female and have just started treatment about a month ago, my doc has me on truvada/reyataz and norvir. I have recently noticed that my belly seems to be getting fat not bloated or anything more like fat rolls when i sit down and it even appears to have cellulite on it. I find this a bit gross and was just wondering if it was the meds and if this would happen so quickly after starting and if it will get worse? I have started to eat healthier (i used to eat alot of junk) and do some tummy excercises as I really dont want this to get out of control!! Thanks for you help...L.

weight gain after starting effective HIV meds is seen fairly consistently during first 6-12 months for a wide range of regimens. The weight gain is mostly fat and often involves stomach area and is most often in the 5-10 pound range. After that the weight gain tends to level off and for some regimens there is fat loss from places like fat and arms/legs. Fat loss has not been much of a problem with your current regimen and high levels of fat gain have also not been seen on a general basis. There may be a small subset of patients who gain fat excessively with some having a genetic predisposition. I cannot with any level of confidence at this point recommend an alternative regimen that would for sure result in loss of abdominal fat without other fat issues or side effects. Data and experience is still lacking regarding fat distribution issues when comparing newer drugs like raltegravir or mavariroc to your current regimen but I am anxious to see if there is any fat distribution benefit with some of the newer drugs. Exercise and diet lifestyle changes are encouraged for a wide range of health reasons as you are doing. There is no simple intervention proven safe and effective for increasing abdominal fat in the setting of treated HIV infection but topic is getting lots of attention. KH