A 39-year-old man with HIV-associated lipodystrophy.
Human immunodeficiency virus (HIV)-associated lipodystrophy refers to fat accumulation, also known as lipohypertrophy, and fat wasting, also known as lipoatrophy. Both conditions can be very disturbing to patients and have been associated with metabolic disturbances such as insulin resistance and hyperlipidemias. The prevalence of HIV-associated lipodystrophy ranges from 6% to 69% in the medical literature. Although no clear associations have been made between specific drugs and HIV lipohypertrophy, stavudine and zidovudine have been implicated in the development of HIV lipoatrophy. The case of Mr B, a 39-year-old man with HIV-associated lipodystrophy whose facial changes are a cause of significant distress, highlights the need for clinicians to be attuned to the psychological impact that lipodystrophy can have on patients, especially because it may serve as a disincentive to adherence to antiretroviral drug regimens, resulting in an increased risk of developing viral resistance.
Fuller
Jon
J
Boston University School of Medicine, and Center for HIV/AIDS Care and Research, Boston Medical Center, Boston, Massachusetts 02118, USA. jfuller@bu.edu
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001672:Biocompatible Materials / Q000008:administration & dosage; D001828:Body Image; D003357:Cosmetic Techniques; D004032:Diet; D015444:Exercise; D005145:Face; D013007:Growth Hormone-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D039682:HIV-Associated Lipodystrophy Syndrome / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D019344:Lactic Acid / Q000008:administration & dosage; D015187:Lipectomy; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage; D012649:Self Concept; D045162:Thiazolidinediones / Q000627:therapeutic use
D019380:Anti-HIV Agents; D001672:Biocompatible Materials; D007004:Hypoglycemic Agents; D011091:Polyesters; D011108:Polymers; D045162:Thiazolidinediones; D019344:Lactic Acid; C033616:poly(lactide); D013007:Growth Hormone-Releasing Hormone; D008687:Metformin; C479538:tesamorelin