35 yo male, positive for 12 years, current meds are Viread, Kaletra and Rescriptor. I have noticed that my stomach is bloated most of the time and have on-going diarrea. What is the risk of worsening lypodystrophy on this regimen?

There are now good long-term data on Viread to show that lipodystrophy is quite rare on this medication. The same can be said of Rescriptor, although it is used much less frequently in clinical practice.

Although lipodystrophy can sometimes occur without any medications being involved, the Kaletra is the likeliest one to be associated with its development (at least considering the medications you are on).

A number of strategies have been tried to address this issue. For instance, if your viral load is undetectable, you could make a single drug switch from the Kaletra to nevirapine, or perhaps to atazanavir (although there are significantly less data for the atazanavir strategy).