Hi; Successful 3 year treatment on sustiva/truvada, have never had an OI. I'm 42 and have noticed that most of the fat is gone from my shins and the tops of my feet, as I have gone down a shoe size and all shoes are painful to the tops of my feet, especially if thinner dress socks are worn. Any treatments on the horizon for this type of lipoatrophy?

Effective intervention for peripheral extremity fat loss occurring when taking Sustiva/Truvada is not currently available to my knowledge. Ordinarily fat loss on that combination has been minimal compared to many other regimens. It is unclear whether switching to any other HIV medication would reverse the problem. Uridine supplements are being looked at but the positive reports have generally been among patients taking a thymdidine analogue (AZT or D4T) so little data is available about benefit whhile on a regimen such as yours. This is a hot area in HIV therapy and fat research so hopefully more will be learned that will translate into more effective treatment in the future. For now the situation is frustrating. KH