HIV-1 protease inhibitor-associated partial lipodystrophy: clinicopathologic review of 14 cases.
BACKGROUND
A novel type of acquired partial lipodystrophy resulting from chronic treatment with HIV-1 protease inhibitor drugs has recently been described.


OBJECTIVE
We studied the clinical and histopathologic features of a series of patients with HIV-1 protease inhibitor-associated lipodystrophy to evaluate the frequency of associated abnormalities.


METHODS
The study group consisted of 14 consecutive HIV-infected patients receiving treatment with HIV-1 protease inhibitors, who experienced partial lipodystrophy. Clinical (including anthropometric data) and histopathologic findings, as well as biochemical and virologic data, were evaluated.


RESULTS
A significant loss of fat in the face and extremities was associated with fat deposition on the abdomen, breast, and dorsocervical fat pad. Central obesity was frequently present. Histopathologic features disclosed a peculiar type of involutional lipodystrophy. Hypertriglyceridemia was detected in 78.5% of patients. Low serum levels of cholesterol-high-density lipoprotein and high cholesterol-very-low-density lipoprotein were noted. Hyperglycemia, hypercholesterolemia, or hyperinsulinemia were occasionally detected.


CONCLUSIONS
HIV-1 protease inhibitor-associated lipodystrophy represents a new entity with peculiar clinical and histopathologic features. Metabolic associated abnormalities may imply a risk of future atherogenic complications.
Pujol
R M
RM
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Domingo
P
P
Xavier-Matias-Guiu
Francia
E
E
Sanbeat
M A
MA
Alomar
A
A
Vazquez
G
G
D000328:Adult; D000886:Anthropometry; D001823:Body Composition; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000139:chemically induced; D011480:Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
D011480:Protease Inhibitors