Ritonavir is a protease inhibitor and can cause hyperiglyceridemia and hypercholesterolemia. All protease inhibitors are metabolized by liver and all can cause metabolic abnormalities including hypercholesterolemia, diabetes mellitus, hyperlipidemia, insulin resistance and altered fat istribution (lipodystrophy). Atazanavir is devoid of this adverse effect. Tesamorelin is a synthetic analogue of growth hormone releasing factor indicated to reduce excess abdominal fat in HIV-infected patients with lipodystrophy.