Dear Doc. I will appreciate a lot your response. I am 38 years old men with HIV since 1986, 1.69 m, 100 Kg (200 lb), CD4 73, and VL 290,000. Taking Kaletra, Stavudine, Sertraline and Lamivudine. Now I am having problem with "fatty balls" in arms, back, all my thorax and abdomen (I have more less 18). I have taken 10 different antiviral meds, I have resistance for them. In addition, my stomach is "inflated" all the time; my ribs hurt my abdominal organs. I have read about lipodistrophy and changes in sugar and lipids levels in the blood of people taking HAART. My question is: Could you recommend me some nutrition or medical way for diminishing my fat trouble and avoid sugar complications? I do not know if it is good for me, and how to loss, weight. In addition, I practice taekwondo but getting tired faster every time. Thanks a Lot Martin GM (Mxico)

Tough situation. I would have your hormone levels checked (thyroid and testosterone) and get a glucose tolerance test. If you have any evidence of insulin resistance you might consider one of the oral diabetic meds (metformin or rosiglitazone) under careful supervision. Also talking to a nutritionist might be helpful to optimize your diet. KH