I would like to know whether side effects of ART can be reversed. In particular buffalo hump and excessive weight gain. I have been taking truvada and efavirenz for the last 3 years. What can I do to normalise my body weight?

Patients taking Truvada + efavirenz often gain weight. It remains unclear how much of that is due to the drugs versus control of HIV versus what might be expected in the general HIV- population. A full nutrition/exercise evaluation is recommended. Genetic factors (comparing body fat distribution to other family members), aging, time with HIV, how low the CD4 count ever went-and many other factors can influence body fat amount and distribution. The amount of fat gained due to Truvada + efavirenz generally compares favorably to other HIV regimens so switching to alternative regimen often will not help much. There is no simple or safe medication proven to reduce body fat on a long term basis in the setting of HIV treatment so that issue remains a vexing and frustrating one for many patients. Exercise and diet remain the first line of treatment in most cases though success rates vary and often requires life style changes that challenge many persons. KH