tested positive in 1986...had liposuction on neck/upperback in 1994 fat came back within 6 months....went up to 183 lbs. eating right & exercise down to 159(...female 5'3") currently on epzicom, norvir, & reyataz...continue to have accumulated fat on back, stomach....(exercise has helped upper arm fat & upper back fat...but not lower back fat) anything else that would help this.....also is there anything I can do for the sucked in cheeks? makes me look sickly

It is difficult to recommend an alternative HIV regimen that would clearly have a better effect on your fat distribution than your current regimen though other regimens could be considered depending on treatment history/resistance status (such as NRTI sparing regimens and/or raltegravir based regimen). Growth hormone or growth hormone releasing factor may provide some benefit for fat increase (costly, not FDA approved, needs to be injected). Fat loss in face has not been a significant issue with your current regimen but there may be persons who are genetically or otherwise more uniquely susceptible. Numerous plastic surgury interventions (such as injection of Sculptra) can provide cosmetic benefit for facial fat loss (expensive and often not covered by insurance). Medical treatments for fat loss are still under investigation (such as some diabetes meds) and can not be routinely recommended at this time. Issue remains frustrating as of 2009. KH