title: Fat redistribution syndromes associated with HIV-1 infection and combination antiretroviral therapy.
abstract: More than 15 years after the introduction of highly active antiretroviral therapy, HIV/HAART-associated lipodystrophy syndrome still shadows the indisputable efficacy of antiretroviral therapy. Several issues related to this complication (prevalence, diagnosis, pathogenesis, prevention, or clinical management) have not been completely clarified. However, in the last years, substantial progress has been made in elucidating some of these basic aspects. This includes a better knowledge of the pathogenic mechanisms underlying HIV/HAART-associated lipodystrophy syndrome such as genetic host determinants, the impact of HIV infection per se, as well as the contribution of antiretroviral therapy. In regard to treatment, we have learned that certain drugs are especially prone to cause HIV/HAART-associated lipodystrophy syndrome (i.e. thymidine analogues). Pharmacological interventions to treat this condition have yielded mostly disappointing results, and the only intervention which offers an immediate aesthetical improvement for patients with HIV/HAART-associated lipodystrophy syndrome is plastic surgery. Even under the most favorable conditions (ideal host genetic make-up, and the timely initiation of HIV therapy with less toxic drugs), current data show that HIV/HAART-associated lipodystrophy syndrome is a complication of HIV infection and/or antiretroviral treatment that we are unable to avoid. In the context of HIV-1-infected patients under long-term antiretroviral therapy, fat toxicity is still the dark side of the rainbow.
authors.affiliation: Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. pdomingo@santpau.cat
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Vicente
authors.initials: V
authors.lastname: Estrada
authors.forename: José
authors.initials: J
authors.lastname: López-Aldeguer
authors.forename: Francesc
authors.initials: F
authors.lastname: Villaroya
authors.forename: Esteban
authors.initials: E
authors.lastname: Martínez
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active; D004359:Drug Therapy, Combination; D005260:Female; D015497:HIV-1 / Q000187:drug effects*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000601:surgery; D006801:Humans; D008297:Male; D011788:Quality of Life; D012307:Risk Factors; D013518:Surgery, Plastic
chemical_list: D019380:Anti-HIV Agents