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HIV-Associated Lipodystrophy and Lipoatrophy 

HIV-Associated Lipodystrophy and Lipoatrophy
Chapter:
HIV-Associated Lipodystrophy and Lipoatrophy
Author(s):

Rajagopal V. Sekhar

DOI:
10.1093/med/9780190493097.003.0046
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date: 29 October 2020

Patients with HIV have been seen to manifest unusual changes in body habitus that constitute variable combinations of peripheral fat loss ( lipoatrophy), central fat accumulation (lipohypertrophy), and the condition known as HIV-associated lipodystrophy (HAL). Although the origins of HAL are unclear, several factors have been linked to it. Because better antiretroviral therapy (ART) drug regimens have led to increased longevity, it is possible that the natural evolution of metabolic complications of HIV is the lipodystrophic phenotype. The specific effects of antiretroviral medications have also been implicated, and the initial usage of ART in the 1990s was accompanied by multiple reports of abnormalities in body fat distribution variously termed the “protease paunch,” “crixivan belly,” among others. Other factors include immune phenomenon and effects mediated directly by the HIV virus. Despite intensive research to understand the mechanistic underpinnings of HIV lipodystrophy and lipoatrophy, the answers remain elusive.

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