i am not clear on the lypodystrophy isssue. are certain aids drugs causing this/ and, can there be other drugs which will not cause so much fat gain? my brother has a lot of fat in his stomache. he looks nine month pregnant. and is also starting to locate on his sides. i wrote earlier, and thank you for your response. but, what are his alternatives if any? switching drugs, liposuction in his torso? he is on viramune, isentress, reyataz. his hiv doctor told him if he wants the fat gone, to quit his drug regime completely. that sounds a little scarey. linda

There are many factors involved with fat gain/loss in setting of HIV infection so in most cases no easy answers/treatment options or even data. The current regimen has not been linked yet to much worsening of fat problems but many older regimens have been (if he was on other treatments previously which seems likely). Not easy or possible to remove fat from within the abdomen. Stopping HIV meds leads to return of pretreatment HIV levels, a drop in CD4 count, risk for serious health problems, and no guarantee that fat problems would resolve. No easy answers for most patients at present other than switching off most offending meds=thymidine analogies such as D4T or AZT (not a part of current regimen). KH