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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Body fat and weight increase treatment
Dec 9, 2011

Since starting ARV's 6 years ago I have put on 25 pounds and have lost the lean muscle look I once had. Despite continuing with the gym 4-5 days a week, taking extra cardio classes and having a good diet. I have read about, and been told by other, of the benefit of Winstrol Depot (Stanozolol)to help reduce fat accumulation. My MD refuses to consider even a trial of this due to potential side effects (My labs are good). Is there significant evidence of liver damage associated with low-dose treatment (1cc per week)? Any other options available to reduce fat before it becomes a larger issues?

Response from Dr. Henry

Reduction of increased fat seen in setting of treated HIV infection remains a challenge. In some cases represents a return to "health" as HIV effect on body metabolism is diminished. Famly genetics, diet, exercise patters, and certain HIV drugs all can contribute to body fat issues. There has been little formal evaluation (with publication in quality medical journal) of stanozolol for HIV associated fat increased. It has been used a fair amount to decrease fat in body builders and HIV+ persons. There is a concern for occasionaly severe liver damaage though the rate for that seems low (again-good studies lacking) as well as potential for drug interactions. To my knowledge there is no study demonstrating safety and clinical benefit in patients with stable weight doing well on HIV treatment. A study by the ACTG in the US to assess benefit of testosterone for treatment of fat gains showed mimimal benefit with most of the fat loss being from subcutaneious compartment (below skin-a look that many body builders like but not generally where the fat problem is for HIV+ persons) with little benefit for intraabdominal (visceral) fat. If any reader has a reference or personal experience to help with the discussion please post. KH

Editor's note: Readers interested in treatment for visceral fat accumulation might also look into Egrifta (tesamorelin).

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