Just started salvage therapy consisting of tenofovir, Kaletra, 3TC and Ziagen. Does Kaletra tend to cause facial lipoatrophy (like D4T apparently does) or is it more likely to cause fat gain... Also, would you recommend having your testosterone levels checked while on Kaletra?

As with other ARV regimens, especially those that combine a PI and nucleoside analog, patients on Kaletra with nucleoside analogs may experience either or both visceral fat gain and subcutaneous fat loss. The PI component of the regimen has been more associated with fat gain, but it is tough to predict what patients will actually end up with. If you have symptoms suggestive of testosterone deficiency (e.g., fatigue, depression, loss of libido, loss of lean body mass) you should consider having your testosterone checked, but Kaletra has not been shown to be any worse than the other ARVs in causing testosterone deficiency.