Practical Review of Recognition and Management of Obesity and Lipohypertrophy in Human Immunodeficiency Virus Infection.
BACKGROUND
Obesity and lipohypertrophy are common in treated human immunodeficiency virus (HIV) infection and contribute to morbidity and mortality among HIV-infected adults on antiretroviral therapy (ART).


METHODS
We present a consensus opinion on the diagnosis, clinical consequences, and treatment of excess adiposity in adults with treated HIV infection.


RESULTS
Obesity and lipohypertrophy commonly occur among HIV-infected adults on ART and may have overlapping pathophysiologies and/or synergistic metabolic consequences. Traditional, HIV-specific, and ART-specific risk factors all contribute. The metabolic and inflammatory consequences of excess adiposity are critical drivers of non-AIDS events in this population. Although promising treatment strategies exist, further research is needed to better understand the pathophysiology and optimal treatment of obesity and lipohypertrophy in the modern ART era.


CONCLUSIONS
Both generalized obesity and lipohypertrophy are prevalent among HIV-infected persons on ART. Aggressive diagnosis and management are key to the prevention and treatment of end-organ disease in this population and critical to the present and future health of HIV-infected persons.
Department of Medicine, University of Texas Health Science Center at Houston.
Jordan E
JE
Lake
Department of Pediatrics, Harvard University School of Medicine and.
Takara L
TL
Stanley
Departments of Medicine and.|Pediatrics, Boston University School of Medicine, Massachusetts.
Caroline M
CM
Apovian
Departments of Medicine and.
Shalendar
S
Bhasin
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Todd T
TT
Brown
Department of Cell Biology and Metabolism, Univ-Paris 6, Inserm UMRS938, ICAN, Paris, France.
Jaqueline
J
Capeau
Department of Medicine, University of California Los Angeles and.
Judith S
JS
Currier
Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles.
Michael P
MP
Dube
Department of Medicine, McGill University, Montreal, Quebec, Canada.
Julian
J
Falutz
Department of Medicine, Harvard University School of Medicine, Boston, Massachusetts.
Steven K
SK
Grinspoon
Department of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy.
Giovanni
G
Guaraldi
Department of Medicine, University of Barcelona, Spain.
Esteban
E
Martinez
Department of Medicine and Pediatrics, Case Western University, Cleveland, Ohio; and.
Grace A
GA
McComsey
Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles.
Fred R
FR
Sattler
Department of Medicine, University of Colorado School of Medicine, Aurora.
Kristine M
KM
Erlandson
D050154:Adiposity / Q000187:drug effects*; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D019468:Disease Management; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000628:therapy*; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D012307:Risk Factors
D019380:Anti-HIV Agents
antiretroviral therapy.; human immunodeficiency virus (HIV); lipohypertrophy; obesity