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You are here : Home  AIDS Factsheet Side Effects And Their Treatments LipodystrophyLipodystrophy
WHAT IS LIPODYSTROPHY? Background Information -What is AIDS? -HIV Testing -Acute HIV Infection -How HIV Drugs Get Approved -HIV Life Cycle Laboratory Tests -Normal Laboratory Values -Complete Blood Count (CBC) -Chemistry Panel -Blood Sugar and Fats -CD4 (T-cell) Tests -Viral Load Tests -HIV Resistance Testing -Monitoring Drug Levels Preventing HIV Infection -Stopping the Spread of HIV -How Risky Is It? -Condoms -Drug Use and HIV -Harm Reduction and HIV -Treatment After Microbicides -Microbicides Living with HIV -Choosing an HIV Care Provider -Medical Appointments -Telling Others You are HIV Positive -Participating in a Clinical Trial -How to Spot HIV/AIDS Fraud -Vaccinations and HIV -Medications to Fight HIV -HIV Life Cycle -Taking Current Antiretroviral Drugs -What Is Antiretroviral Therapy (ART)? -Adherence -Treatment Interruptions -Drug Interactions -Strengthening the Immune System -Immune Therapies in Development -Immune Restoration -Interleukin-2 -Immune Restoration Syndrome -Opportunistic Infections -Opportunistic Infections Side Effects and Their Treatments -Side Effects -Fatigue -Anemia -Body Shape Changes (Lipodystrophy) -Diarrhea -Peripheral Neuropathy -Mitochondrial Toxicity -Bone Problems -Depression and HIV Patient Populations -Women and HIV -Pregnancy and HIV aids -Children and HIV -Older People and HIV Alternative and Complementary Therapies -Alternative and Complementary Therapies -Ayurvedic Medicine -Chinese Acupuncture -Chinese Herbalism -Cat's Claw -DHEA -DNCB (Dinitrochlorobenzene) -Echinacea -Essiac -Marijuana -Silymarin (Milk Thistle) -Nutrition -Nutrition -Vitamins and Minerals -Exercise and HIV -Smoking and HIV
Lipodystrophy, or "lipo" for short, is a collection of body shape changes in people taking anti-HIV medications. "Lipo" refers to fat, and "dystrophy" means bad growth. These changes include fat loss, fat deposits, and metabolic changes.
There is no clear definition of lipo. As a result, doctors report that between 5% and 75% of patients taking antiretroviral medications (ARVs) have some signs of lipo. Most researchers think the true rate is about 50%. These changes were first called "Crix belly", because they were noticed in people taking the protease inhibitor Crixivan (indinavir). However, lipo can develop in people taking almost any type of antiretroviral therapy (ART). IS LIPODYSTROPHY DANGEROUS? Although it is not life threatening, lipodystrophy is a serious problem.
No researcher has suggested that people with lipo should stop taking their ART. WHAT CAUSES LIPODYSTROPHY? We do not know what causes lipo. There may be different causes for the various symptoms. One theory is that protease inhibitors interfere with the body's processing of fat. Protease inhibitor molecules are similar to some human proteins that process and transport fat. However, some patients who have never taken protease inhibitors have lipo. Another theory is that insulin resistance plays a role in lipo. People with insulin resistance tend to gain weight in the abdomen. Lipo may also be similar to "Syndrome X" which can occur in people who have recovered from serious illnesses like childhood leukemia or breast cancer. For people with HIV, this may be caused by the recovery of the immune system after effective ART. In fact, lipo is more common in people who are doing well on their ART. A large study found that the following factors appear to increase the risk of developing lipodystrophy:
CAN LIPODYSTROPHY BE TREATED? Because we don't know what causes lipo, we don't know how to treat it. Body changes sometimes get worse, stop or get better by themselves. Some people stop taking protease inhibitors to try to reverse lipo. Some changes in ART lead to improvements in certain signs of lipo. However, it takes a long time to reverse changes in body shape. Some fat deposits can be cut out surgically, or removed by liposuction. Cosmetic surgery (implants or injections) is the only proven way to deal with sunken cheeks. These procedures have some risks, and the results may only be temporary. There are a few reports of good results from people who increased their exercise, or who changed their diets. Human growth hormone or testosterone might help some lipo symptoms. They are currently being studied. High cholesterol or glucose should be treated the same way as for people without HIV. Some doctors use medications to lower cholesterol and triglycerides, or to improve insulin sensitivity. More attention is being paid to assessing and reducing the risk of heart disease in patients with HIV. THE BOTTOM LINE Lipo is a collection of changes in metabolism and body shape in people taking ARVs. There is no clear definition of lipo. It is difficult to know exactly how many people have it. Also, without knowing what causes lipo, we don't yet know how to treat it. Researchers are looking into hormone therapies and other ways to treat lipo. Changing or stopping antiviral ART is not recommended. Until we know more about specific causes and treatments for lipo, its symptoms are treated the same way as for the general population. You are here : Home AIDS Factsheet Side Effects And Their Treatments Lipodystrophy |
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