Hi Doctor i been on meds 7 yrs. i was wondering if the there is any thing i can do about the bump in the back of my upper back lower neck area its starting to be painful and it feels like a bone growing because its feels hard and have alot of redness and my skin it changing color there in my lower neck. Is it expensive to remove or can it be covered by medicare part-a-b or is it something i have to just live with? Would it grow back even if its removed?

Thank you

An assessment by your HIV provider to determine the nature (all fat/some involvement of C-spine) of the pain (buffalo hump/fat usually has minimal pain). If it is determined that you have a large fat deposit there in the setting of treated HIV infection then there are a number of options including switching meds, surgery/liposuction/ or growth hormone or growth hormone releasing factor. Best choice is individualized and depends on available of particular options and insurance coverage. More insurance companies in US including Medicare have been covering for procedures but such coverage remains uneven and often requires several rounds of letter writing/explanation (frustrating situation for many). KH