Treating body fat and metabolic changes

  • At the moment there is no treatment which will reverse all the body fat changes. Some people who stop treatment altogether report improvements, but may not return to normal, and most people with body fat changes are not in a position to stop taking antiretroviral drugs.
  • Fat deposits on the abdomen and between the shoulder blades may be reduced by taking human growth hormone, but treatment is extremely expensive and must be continued for the improvement to last.
  • A drug used to treat diabetes, called metformin, may be effective in reducing abdominal fat deposits. It also reduces triglyceride levels and improves glucose metabolism.
  • Fat loss from the arms, legs and face may be improved somewhat by switching from d4T to abacavir or tenofovir.
  • A variety of techniques are now being tested to restore the facial appearance of people who have lost fat from the face. Most of these involve injectable substances such as polylactic acid (New Fill), polyalkylimide gel (Bio-Alcamid), and others.
  • Neither fat gain nor fat loss has been improved by switching from a protease inhibitor to NNRTI-based regimen, although there is some evidence from one study that switching to abacavir might help. This needs to be confirmed by further research.
  • Lipid levels may be improved by switching from a protease inhibitor to an NNRTI or abacavir-containing regimen.
  • Both central fat deposits and lipid levels have been improved by a programme of resistance exercise and aerobic exercise. Resistance exercise builds muscles which burn triglycerides, and regular exercise of any sort increases levels of good cholesterol. A brisk walk for half an hour each day reduces the risk of heart disease by one third compared to taking no exercise, according to studies in middle-aged women, and this has a similar degree of benefit to aerobic exercise.
  • Statins are lipid-lowering drugs which have been used successfully to lower lipid levels in people on HIV therapy. The drug used most often is pravastatin.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.