title: An update on the pharmacological strategies in the treatment of HIV-1-associated adipose redistribution syndromes.
abstract: BACKGROUND
  With the introduction of combination antiretroviral therapy (ART) for HIV infection in the mid-1990s, descriptions of morphological changes and metabolic disturbances in treated patients began to emerge. HIV-1/highly active ART-associated lipodystrophy syndrome (HALS) involves metabolic abnormalities and diverse forms of anomalous fat distribution. The current review focuses on the pathophysiological basis and the clinical evidence for the use of several medical strategies in the management of HALS.
  
  
  METHODS
  We have covered the most relevant studies related to the pharmacological strategies in the treatment of HALS, with attention to the current and novel antiretroviral agents.
  
  
  CONCLUSIONS
  The most commonly used strategies for HALS reversion have included modification of host-dependent factors, including those related to HIV-1 infection and those associated with ART. Preventive and medical strategies have been associated with moderate success. The only intervention that offers an immediate aesthetical improvement for patients with HALS so far has been plastic surgery.
authors.affiliation: Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Infectious Diseases Unit , Av. Sant Antoni Ma Claret, 167, 08025 Barcelona , Spain +34 935 56 56 09 ; +34 935 56 59 38 ; pdomingo@santpau.es ; pere.domingo@uab.cat.
authors.forename: María Gracia
authors.initials: MG
authors.lastname: Mateo
authors.forename: María Del Mar
authors.initials: Mdel M
authors.lastname: Gutierrez
authors.forename: Francesc
authors.initials: F
authors.lastname: Vidal
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
mesh_terms: D050154:Adiposity / Q000187:drug effects; D000818:Animals; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015497:HIV-1 / Q000187:drug effects* / Q000302:isolation & purification; D039682:HIV-Associated Lipodystrophy Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006728:Hormones / Q000627:therapeutic use; D006801:Humans
chemical_list: D044966:Anti-Retroviral Agents; D006728:Hormones
keywords: HIV infection; HIV/HAART-associated; NRTIs; antiretroviral therapy; lipoatrophy; lipodystrophy syndrome; lipohypertrophy; protease inhibitors; switching; thymidine analogues