Continued treatment with zidovudine plus lamivudine is expected to result in a (further) decrease in the mass of peripheral adipose tissue. Switching to emtricitabine plus tenofovir disoproxil fumarate is expected to result in an increase or at least the absence of a further loss of peripheral adipose tissue. The combination of emtricitabine plus tenofovir disoproxil fumarate is an attractive backbone of antiretroviral combination therapy. This combination has potent antiretroviral activity, has a favorable resistance profile, ease of once-daily dosing, can be conveniently co-formulated in a single tablet, has no special food requirements, is well tolerated, and thus far has not been particularly associated with the occurrence of mitochondrial toxicity or lipoatrophy. With respect to the latter, the recent Gilead 903 trial has been very informative in the sense that no limb fat wasting (measured by DEXA) was observed between 96 and 144 weeks of treatment as opposed to the progressive limb fat loss which was seen in patients randomized to the stavudine-containing control arm13.