Dear doctor,

I think I will have to start meds this year... But, all that you can read about getting big around the abdomen is so confusing. When you read the messages of people you have to conclude that you will get a big belly couse of the meds. But then when you read articles clever people say there is no real prove... Can you PLEASE tell me if it are the PI's that are the culprits, or that you also get it from NNRTI's... It makes me so afraid, I think sometimes not to start with meds. Also I think my doctor (who is very good and who I trust) doesn't want to talk about it really, of may be he doesn't understand how it upsets me.

If you have access to new meds (ie Truvada, Epzicom, Reyataz, Sustiva, raltegravir) then effective combinations of them have an overall low rate of large accumulations of intra-abdominal fat. Quality of life studies wherein patients are surveyed consistently note that patients feel much better when taking HIV meds compared to patients not taking HIV meds. Of the last several hundred patients started on treatment in our clinic the rate of bothersome abdominal fat increase in < 5 % over the first several years. KH