Hi, I've been positive now for over a year I'm presently taking Viracept, Epivir and Zerit. My CD4 is 614 and my viral load is 56. I'm constantly hearing about how I should gain weight. My genetics is a skinny frame. I'm 5'9'', 140 lbs. My Dad is skinny too. I can work out but don't really gain much muscle and when I just eat a lot I do gain weight but its all fat (around the waist ) and the fat look is not my cup of tea. Should I ask my doctor for steroids or hormones or something to gain muscle? Or is it ok to stay skinny? I just had my testosterone checked and it was 402... Let me know... Thank you for all your help...

Sincerely Bob

Very insightful questions.

The evidence is that weight loss, not thinness per se, is the health risk. If you've always been a certain way, not changed as a result of HIV infection, is the key issue here.

Also, being fat has no protective value at all. Obese people who get sick and lose weight, have the same health risks as normal weight people who get sick and lose weight (even though the folks who started out obese may still be overweight). So it's the weight loss that is key, again.

The only plus would be if you had a bit more "meat on your bones" (i.e. muscle) it might be a reserve, if you were to go on and lose weight. But this is speculation -- never proven that gaining above a person's normal weight protects in this manner.

If you could work out, therefore, it wouldn't hurt, but we can't be sure that it would help, either. So the main thing is to NOT allow yourself to lose weight. If this starts to occur even slightly, then you really have to be aggressive about taking steps to restore lost muscle mass. This is the real message for you, as a constitutionally thin person: you have less time and less slack before you have to take action, if you start to lose weight!

Good luck.