Doc how many years it takes for lipodystrophy to start showing on someone taking haart? I am taking haart for 5 years now, and I have a mild lipodystrophy would it get worst. I am not sure when it started because when I went on haart I was already skinny. Then I gain weight but not very much.

There is no precision to the term lipodystrophy. It includes aspects of fat wasting (or atrophy) which occurs in the face and arms and legs. It also includes fat gain in the abdominal area and neck. Some of those body changes occur with aging. HIV infection itself might play a role as could the immune recovery seen with successful treatment. There are many questions but few answers. A proactive approach is a good idea but without a better idea of what is going on it can be very frustrating. Exercising, a good diet, and good hormone levels (i.e. testosterone) may help some. Some drugs might cause more problems than others. Depending on what aspect of lipodystrophy you are experiencing, a discussion with your doctor about whether a change in your HIV medications might be warranted. Interventions such as use of oral diabetes drugs are being studied by the ACTG and other groups. Growth hormone is also being studied in this setting. Since this is such an important topic, participation in research studies to shed light on the how and why issues is still crucial. Mild lipodystrophy after 5 years would be not at all surprising. The percent of persons with lipodystrophy in the setting of treatment for HIV has varied widely due to the lack of a precise definition. KH