title: Management of fat accumulation in patients with HIV infection.
abstract: The use of antiretroviral therapies has improved survival in people living with HIV to nearly normal rates. However, ongoing low-level HIV replication and incomplete immune recovery are associated with a chronic inflammatory stimulus. This increases several non-typically AIDS-related complications, including fat mass changes and metabolic conditions. Abdominal adiposity occurs as a result of complex interactions involving HIV itself, antiretroviral drug-associated factors, and several intermediary metabolic alterations and abnormal hormone levels. Abdominal adiposity in turn can further the metabolic derangements, and increase the risk of diabetes and cardiovascular disease. Abnormal growth hormone secretion plays a role in development of the fat depot changes. Effective long-term interventions to decrease central adiposity are limited but studies using growth hormone and especially growth hormone-releasing factor have shown encouraging results. Other emerging therapeutic options have been variably successful in the short term and the continuing clinical and therapeutic challenges will require ongoing investigation.
authors: Immunodeficiency Treatment Center, McGill University Health Center, Montreal, Quebec, Canada. julian.falutz@muhc.mcgill.ca
authors: Julian
authors: J
authors: Falutz
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D013007:Growth Hormone-Releasing Hormone / Q000627:therapeutic use*; D006678:HIV; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced / Q000188:drug therapy* / Q000378:metabolism* / Q000821:virology; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008297:Male
chemical_list: D013006:Growth Hormone; D013007:Growth Hormone-Releasing Hormone