I am 45/male/poz since 82 Started azt 85, several regimens since, past 4 months on: Kaletra/Sustiva/Ziagen/ Zerit/3TC. Counts now mid 300s@16/undetectable. Only lasting side effects have been intermittent watery stools/urgencies and insomnia, and lipodystrophy (face and legs). Am taking CoQ10/Acetyl L Carnotine/Niacin. I have 2 Qns: After taking p.m. meds with only a light meal the other day,I awoke at 4 a.m. for the bathroom, and suddenly felt flushed, dizzy and nauseous; got up from the toilet and fainted. Could that be from not having eaten enough? 2: Is there any further research to support these supplements to aid against the lipo? Sorry this is so long, thx for your help. David

Your fainting episode could be due to a # of factors: Sustiva CNS effect, mild dyhydration, vasovagal factors (standing up/valsalva when going to the bathroom), hypoglycemia--and others. Your HIV doc will have to help sort out. Your supplement cocktail is seeing wide use for lipodystrophy without much hard data that it helps. The ACTG is studying the use of several diabetic meds (Metformin and or Avandia) for lipodystrophy. Lipostrophy seems to be even more a problem than fat excess. Lots of work is going into this important areas but answers are not available. We must try to remain patient which is very frustrating. Plastic surgery on the face is an option for those who can afford it. KH