title: New and emerging agents in the management of lipodystrophy in HIV-infected patients.
abstract: Lipodystrophy remains a major long-term complication in human immunodeficiency virus-infected patients under antiretroviral (ARV) therapy. Patients may present with lipoatrophy or lipohypertrophy or both. The choice of treatments to improve fat redistribution depends on the form of lipodystrophy and its duration. Measures known to improve lipoatrophy are switches in ARV therapy (stavudine or zidovudine to abacavir or tenofovir) and filling interventions. Pioglitazone may be added to these measures, although any benefits appear small. Uridine and leptin were found to be disappointing so far. Regarding lipohypertrophy, diet and exercise, recombinant human growth hormone, and metformin may reduce visceral fat, but may worsen subcutaneous lipoatrophy. Surgical therapy may be required. Attractive pharmacologic treatments include growth hormone-releasing factor and leptin. Adiponectin and adiponectin receptors are promising therapeutic targets to explore.
authors.affiliation: Service des Maladies Infectieuses, Hôpital Purpan, Toulouse, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Bonnet
references.citation: AIDS. 2009 Jun 1;23(9):1109-18
references.pmid: 19417580
references.citation: AIDS. 2002 Dec 6;16(18):2447-54
references.pmid: 12461419
references.citation: J Clin Endocrinol Metab. 2003 Feb;88(2):627-36
references.pmid: 12574192
references.citation: AIDS. 2006 Apr 24;20(7):1003-10
references.pmid: 16603852
references.citation: AIDS Care. 2008 Nov;20(10):1197-201
references.pmid: 18608076
references.citation: AIDS Patient Care STDS. 2008 Jul;22(7):577-85
references.pmid: 18647097
references.citation: AIDS Patient Care STDS. 2009 Sep;23(9):699-714
references.pmid: 19673594
references.citation: AIDS Patient Care STDS. 2002 Aug;16(8):375-88
references.pmid: 12227988
references.citation: AIDS Patient Care STDS. 2006 Dec;20(12):829-37
references.pmid: 17192148
references.citation: Metabolism. 2006 Oct;55(10):1327-36
references.pmid: 16979403
references.citation: AIDS. 2008 Aug 20;22(13):1561-8
references.pmid: 18670214
references.citation: J Acquir Immune Defic Syndr. 2002 Aug 1;30(4):379-91
references.pmid: 12138344
references.citation: AIDS. 2003 Jul 4;17(10):1503-11
references.pmid: 12824788
references.citation: AIDS. 2004 Apr 30;18(7):1029-36
references.pmid: 15096806
references.citation: AIDS Res Hum Retroviruses. 2004 Aug;20(8):813-5
references.pmid: 15320984
references.citation: Clin Infect Dis. 2002 May 15;34(10):1396-405
references.pmid: 11981737
references.citation: Mol Pharmacol. 1991 May;39(5):625-8
references.pmid: 1851960
references.citation: Antivir Ther. 2006;11(2):179-86
references.pmid: 16640099
references.citation: J Acquir Immune Defic Syndr. 2000 Oct 1;25(2):130-9
references.pmid: 11103043
references.citation: J Acquir Immune Defic Syndr. 2001 Jul 1;27(3):237-44
references.pmid: 11464142
references.citation: Antivir Ther. 2003 Oct;8(5):403-10
references.pmid: 14640387
references.citation: AIDS. 2005 Jun 10;19(9):917-25
references.pmid: 15905672
references.citation: AIDS. 2008 Sep 12;22(14):1769-78
references.pmid: 18753860
references.citation: Plast Reconstr Surg. 2004 Aug;114(2):551-5; discussion 556-7
references.pmid: 15277830
references.citation: J Acquir Immune Defic Syndr. 2007 Dec 15;46(5):581-9
references.pmid: 18193500
references.citation: Clin Infect Dis. 2010 Apr 1;50(7):1033-40
references.pmid: 20192724
references.citation: Antivir Ther. 2008;13(1):67-76
references.pmid: 18389900
references.citation: Antivir Ther. 2007;12(4):489-500
references.pmid: 17668557
references.citation: HIV Med. 2010 Sep;11(8):493-501
references.pmid: 20236365
references.citation: J Clin Endocrinol Metab. 2009 Apr;94(4):1137-44
references.pmid: 19174500
references.citation: AIDS. 2000 Jul 7;14(10):1309-16
references.pmid: 10930144
references.citation: Lancet. 2002 Mar 23;359(9311):1026-31
references.pmid: 11937183
references.citation: HIV Med. 2003 Jul;4(3):293-301
references.pmid: 12859330
references.citation: Clin Infect Dis. 2004 Sep 1;39(5):732-5
references.pmid: 15356790
references.citation: J Clin Endocrinol Metab. 2008 Jan;93(1):139-46
references.pmid: 17940111
references.citation: AIDS. 2005 Aug 12;19(12):1279-87
references.pmid: 16052083
references.citation: HIV Clin Trials. 2008 Jul-Aug;9(4):254-68
references.pmid: 18753120
references.citation: Dermatol Surg. 2001 May;27(5):497-500
references.pmid: 11359503
references.citation: J Acquir Immune Defic Syndr. 2005 Feb 1;38(2):156-62
references.pmid: 15671800
references.citation: AIDS Rev. 2009 Jul-Sep;11(3):126-34
references.pmid: 19654854
references.citation: Eur J Clin Nutr. 2008 Aug;62(8):1031-7
references.pmid: 17538545
references.citation: AIDS. 2009 Jul 17;23(11):1349-57
references.pmid: 19474651
references.citation: AIDS. 1999 Sep 10;13(13):1659-67
references.pmid: 10509567
references.citation: Clin Chem Lab Med. 2007;45(7):815-21
references.pmid: 17617020
references.citation: Clin Infect Dis. 2003 Nov 15;37(10):1374-7
references.pmid: 14583872
references.citation: Clin Infect Dis. 2005 Jun 15;40(12):1837-45
references.pmid: 15909274
references.citation: Top HIV Med. 2008 Oct-Nov;16(4):127-33
references.pmid: 18838747
references.citation: Clin Infect Dis. 2002 Mar 1;34(5):649-57
references.pmid: 11810598
references.citation: J Clin Endocrinol Metab. 2006 Jul;91(7):2605-11
references.pmid: 16636130
references.citation: J Acquir Immune Defic Syndr. 2003 Jan 1;32(1):48-56
references.pmid: 12514413
references.citation: AIDS Rev. 2008 Jul-Sep;10(3):152-61
references.pmid: 18820717
references.citation: J Am Acad Dermatol. 2008 Dec;59(6):923-33
references.pmid: 19022099
references.citation: J Acquir Immune Defic Syndr. 2010 Jun;54(2):197-203
references.pmid: 20035231
references.citation: J Clin Densitom. 2010 Apr-Jun;13(2):237-44
references.pmid: 20347366
references.citation: J Clin Endocrinol Metab. 2007 Mar;92(3):1049-57
references.pmid: 17164307
references.citation: J Clin Endocrinol Metab. 2002 Oct;87(10):4611-5
references.pmid: 12364443
references.citation: J Acquir Immune Defic Syndr. 2007 May 1;45(1):60-5
references.pmid: 17356466
references.citation: AIDS. 2001 Jul 27;15(11):1389-98
references.pmid: 11504960
references.citation: Am J Infect Dis. 2006;2(3):141-152
references.pmid: 17183414
references.citation: Antivir Ther. 2009;14(3):371-80
references.pmid: 19474471
references.citation: AIDS. 2000 Jan 7;14(1):37-49
references.pmid: 10714566
references.citation: Antivir Ther. 2005;10(6):753-9
references.pmid: 16218175
references.citation: Arch Intern Med. 2006 Jun 12;166(11):1225-31
references.pmid: 16772251
references.citation: Antivir Ther. 2007;12(1):97-105
references.pmid: 17503753
references.citation: Clin Infect Dis. 2001 Jun 15;32(12):1769-75
references.pmid: 11360219
references.citation: J Acquir Immune Defic Syndr. 2009 Aug 15;51(5):562-8
references.pmid: 19561519
references.citation: AIDS. 2003 Nov 21;17(17):2471-7
references.pmid: 14600518
references.citation: Clin Infect Dis. 2006 Sep 1;43(5):645-53
references.pmid: 16886161
references.citation: Diabetes. 1996 Jul;45(7):881-5
references.pmid: 8666137
references.citation: Horm Metab Res. 2009 Nov;41(11):840-5
references.pmid: 19598076
references.citation: Antivir Ther. 2009;14(1):85-92
references.pmid: 19320240
references.citation: J Acquir Immune Defic Syndr. 2003 Sep 1;34(1):58-61
references.pmid: 14501794
references.citation: AIDS. 1999 Mar 11;13(4):465-71
references.pmid: 10197374
references.citation: J Antimicrob Chemother. 2008 Oct;62(4):648-60
references.pmid: 18565973
references.citation: JAMA. 2004 Jul 14;292(2):210-8
references.pmid: 15249570
references.citation: J Am Acad Dermatol. 2005 Feb;52(2):233-9
references.pmid: 15692467
references.citation: AIDS. 2002 Sep 27;16(14):1985-7
references.pmid: 12351969
references.citation: J Clin Densitom. 2010 Apr-Jun;13(2):197-203
references.pmid: 20347364
references.citation: J Acquir Immune Defic Syndr. 2007 Jun 1;45(2):193-200
references.pmid: 17527093
references.citation: HIV Clin Trials. 2009 Sep-Oct;10(5):314-9
references.pmid: 19906628
references.citation: J Acquir Immune Defic Syndr. 2009 Jun 1;51(2):111-6
references.pmid: 19339895
references.citation: J Acquir Immune Defic Syndr. 2001 Jul 1;27(3):229-36
references.pmid: 11464141
references.citation: N Engl J Med. 2003 Sep 11;349(11):1036-46
references.pmid: 12968087
references.citation: J Clin Endocrinol Metab. 2001 Aug;86(8):3480-7
references.pmid: 11502767
references.citation: AIDS. 2003 May 2;17(7):971-9
references.pmid: 12700446
references.citation: PPAR Res. 2009;2009:507141
references.pmid: 19125203
references.citation: N Engl J Med. 2002 Feb 21;346(8):570-8
references.pmid: 11856796
references.citation: N Engl J Med. 2007 Dec 6;357(23):2359-70
references.pmid: 18057338
references.citation: AIDS. 2007 Jan 2;21(1):47-57
references.pmid: 17148967
references.citation: HIV Med. 2008 Feb;9(2):72-81
references.pmid: 18257770
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Nov 1;19(3):307-8
references.pmid: 9803975
references.citation: J Acquir Immune Defic Syndr. 2003 Aug 15;33(5):571-6
references.pmid: 12902800
references.citation: AIDS. 2000 Sep 8;14(13):2055
references.pmid: 10997414
references.citation: AIDS. 2001 Jan 26;15(2):231-9
references.pmid: 11216932
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Mar 1;20(3):228-37
references.pmid: 10077170
references.citation: Diabetologia. 2004 Oct;47(10):1668-71
references.pmid: 15455200
references.citation: Trans R Soc Trop Med Hyg. 2010 Feb;104(2):148-53
references.pmid: 19732926
references.citation: Lancet. 2000 Oct 21;356(9239):1412-3
references.pmid: 11052589
references.citation: J Acquir Immune Defic Syndr. 2005 Aug 1;39(4):395-400
references.pmid: 16010159
references.citation: Antivir Ther. 2004 Dec;9(6):911-20
references.pmid: 15651750
references.citation: Plast Reconstr Surg. 1999 Nov;104(6):1814-20; discussion 1821-2
references.pmid: 10541186
references.citation: AIDS. 2006 Sep 11;20(14):1813-21
references.pmid: 16954722
references.citation: AIDS. 1999 May 28;13(8):1000-2
references.pmid: 10371188
references.citation: Curr HIV Res. 2007 Sep;5(5):459-66
references.pmid: 17896965
references.citation: Lancet. 2003 Mar 1;361(9359):726-35
references.pmid: 12620736
references.citation: AIDS. 1999 Nov 12;13(16):2311-2
references.pmid: 10563722
references.citation: J Clin Endocrinol Metab. 2001 May;86(5):1930-5
references.pmid: 11344187
references.citation: J Clin Endocrinol Metab. 2002 Nov;87(11):4845-56
references.pmid: 12414837
references.citation: AIDS Read. 2004 Dec;14(12):639-40, 645-50
references.pmid: 15619779
references.citation: BMC Infect Dis. 2010 Jun 23;10:183
references.pmid: 20573187
references.citation: J Acquir Immune Defic Syndr. 2003 Aug 15;33(5):564-70
references.pmid: 12902799
references.citation: AIDS Patient Care STDS. 2002 Jul;16(7):307-11
references.pmid: 12194727
references.citation: Antivir Ther. 2007;12(6):919-29
references.pmid: 17926646
references.citation: AIDS Res Hum Retroviruses. 2008 Feb;24(2):169-71
references.pmid: 18240956
references.citation: Diabetes Res Clin Pract. 2008 Feb;79(2):214-9
references.pmid: 17935818
references.citation: J Acquir Immune Defic Syndr. 2004 Mar 1;35(3):239-52
references.pmid: 15076238
references.citation: Facial Plast Surg. 2004 May;20(2):157-63
references.pmid: 15643584
references.citation: Can J Infect Dis Med Microbiol. 2005 Jul;16(4):233-43
references.pmid: 18159551
references.citation: Clin Exp Immunol. 2004 Feb;135(2):273-9
references.pmid: 14738456
references.citation: HIV Med. 2001 Jul;2(3):163-5
references.pmid: 11737396
references.citation: AIDS. 1998 Oct 1;12(14):1735-44
references.pmid: 9792373
references.citation: J Acquir Immune Defic Syndr. 2009 Jun 1;51(2):224-30
references.pmid: 19339897
references.citation: AIDS. 2006 Sep 11;20(14):1843-50
references.pmid: 16954725
references.citation: AIDS. 2001 Oct 19;15(15):1917-30
references.pmid: 11600819
references.citation: Mini Rev Med Chem. 2007 Jan;7(1):39-45
references.pmid: 17266636
references.citation: J Acquir Immune Defic Syndr. 2007 Jul 1;45(3):286-97
references.pmid: 17592343
references.citation: J Acquir Immune Defic Syndr. 2002 Dec 15;31 Suppl 3:S140-4
references.pmid: 12562038
references.citation: Qual Life Res. 2006 Jun;15(5):767-75
references.pmid: 16721637
references.citation: Curr HIV Res. 2010 Jul;8(5):364-9
references.pmid: 20353389
references.citation: AIDS. 2006 Oct 24;20(16):2043-50
references.pmid: 17053350
references.citation: J Acquir Immune Defic Syndr. 2007 Dec 1;46(4):451-5
references.pmid: 18077834
references.citation: Sex Transm Infect. 2003 Apr;79(2):137-41
references.pmid: 12690137
references.citation: HIV Clin Trials. 2010 Jan-Feb;11(1):39-50
references.pmid: 20400410
references.citation: Clin Infect Dis. 2003 Mar 15;36(6):795-802
references.pmid: 12627366
references.citation: AIDS. 2008 Mar 12;22(5):575-84
references.pmid: 18316998
references.citation: AIDS Read. 2003 Nov;13(11):539-42, 559
references.pmid: 14649623
references.citation: Endokrynol Pol. 2005 Jan-Feb;56(1):19-24
references.pmid: 16335669
references.citation: HIV Med. 2007 Oct;8(7):420-6
references.pmid: 17760733
references.citation: Plast Reconstr Surg. 2006 Sep;118(3 Suppl):34S-45S
references.pmid: 16936543
references.citation: AIDS Rev. 2010 Jan-Mar;12(1):3-14
references.pmid: 20216906
references.citation: Clin Ther. 2000 Jun;22(6):685-708
references.pmid: 10929917
references.citation: Endocrinology. 2004 Feb;145(2):484-6
references.pmid: 14739152
references.citation: Dermatol Surg. 2006 Nov;32(11):1336-45
references.pmid: 17083585
references.citation: Aesthetic Plast Surg. 2006 Jan-Feb;30(1):98-103
references.pmid: 16402157
references.citation: AIDS. 1999 Jul 30;13(11):1373-5
references.pmid: 10449291
references.citation: J Infect Dis. 2008 Mar 15;197(6):858-66
references.pmid: 18419350
references.citation: Clin Infect Dis. 2000 Nov;31(5):1274-8
references.pmid: 11073763
references.citation: AIDS. 2000 Mar 10;14(4):468-9
references.pmid: 10770555
references.citation: AIDS. 2002 Apr 12;16(6):859-63
references.pmid: 11919487
references.citation: J Clin Densitom. 2005 Fall;8(3):287-92
references.pmid: 16055958
references.citation: Mitochondrion. 2004 Sep;4(5-6):763-77
references.pmid: 16120431
references.citation: Plast Reconstr Surg. 2004 Jan;113(1):363-70; discussion 371-2
references.pmid: 14707661
references.citation: AIDS Patient Care STDS. 2002 Sep;16(9):413-7
references.pmid: 12396693