- Target Audience
- Overall Learning Objectives
- Faculty
- Physician Continuing Medical Education
- Pharmacist Continuing Education
- Nursing Continuing Education
- Disclosure of Conflicts of Interest
- Disclosure of Unlabeled Use
- 1. Epidemiology and the Spread of HIV
- 2. The Origin, Evolution, and Epidemiology of HIV-1 and HIV-2
- 3. Mechanisms of HIV Transmission
- 4. HIV Transmission Prevention
- 5. Immunology
- 6. HIV Cure Strategies<sup>a</sup>
- 7. HIV Testing and Counseling
- 8. Laboratory Testing Strategies
- 9. The Medical History and Physical Examination of the HIV-Infected Patient
- 10. Initial Laboratory Evaluation and Risk Stratification of the HIV-Infected Patient
- 11. Clinical Syndromes and Differential Diagnosis in the HIV-Infected Patient
- 12. Health Maintenance
- 13. Issues in Specific Patient Populations
- 14. Complementary and Alternative Medicine/Integrative Medicine Approaches
- 15. Care Coordination
- 16. Palliative Care and End-of-Life Support
- 17. HIV Virology
- 18. Principles of Applied Clinical Pharmacokinetics and Pharmacodynamics in Antiretroviral Therapy
- 19. Classes of Antiretrovirals
- 20. Initiation of Antiretroviral Therapy
- 21. HIV-1 Resistance to Antiretroviral Drugs
- 22. Managing the Patient with Multidrug-Resistant HIV
- 23. Future Antiretrovirals, Immune-Based Strategies, and Therapeutic Vaccines
- 24. The Pharmacist’s Role in Caring for HIV-Positive Individuals
- 25. Solid Organ Transplantation in HIV-Infected Individuals
- 26. Antiretroviral Therapy in Pregnant Women
- 27. Antiretroviral Therapy in Children and Newborns
- 28. Immunosuppressants and Antiretroviral Therapy in HIV-Positive Transplant Patients
- 29. Understanding and Managing Antineoplastic and Antiretroviral Therapy
- 30. Substance Abuse in HIV Populations
- 31. Understanding the Use of Antiretroviral Drugs in the Aging Patient
- 32. Opportunistic Infections
- 33. Malignant Diseases in HIV
- 34. Dermatologic Complications
- 35. Endocrine Disorders
- 36. Non-opportunistic Infections
- 37. Psychiatric Illness and Treatment in HIV Populations
- 38. HIV-Associated Neurocognitive Disorders
- 39. HIV/Hepatitis Co-infection
- 40. Ocular Complications
- 41. Cardiovascular Disease
- 42. Renal Complications
- 43. Musculoskeletal Complications of HIV
- 44. Sexually Transmitted Diseases
- 45. HIV and Bone Health
- 46. HIV-Associated Lipodystrophy and Lipoatrophy
- 47. Dyslipidemia
- 48. Immune Reconstitution Inflammatory Syndrome
- 49. US Health Care Systems, HIV Programs, and Coverage Policy Issues
- 50. Legal Issues<sup>a</sup>
- 51. Research Design and Analysis
- 52. Ethical Conduct of Clinical Trials, Institutional Review Boards, Informed Consent, and Financial Conflicts of Interest
- Index
(p. 523) HIV-Associated Lipodystrophy and Lipoatrophy
- Chapter:
- (p. 523) HIV-Associated Lipodystrophy and Lipoatrophy
- Author(s):
Rajagopal V. Sekhar
- DOI:
- 10.1093/med/9780190493097.003.0046
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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- Target Audience
- Overall Learning Objectives
- Faculty
- Physician Continuing Medical Education
- Pharmacist Continuing Education
- Nursing Continuing Education
- Disclosure of Conflicts of Interest
- Disclosure of Unlabeled Use
- 1. Epidemiology and the Spread of HIV
- 2. The Origin, Evolution, and Epidemiology of HIV-1 and HIV-2
- 3. Mechanisms of HIV Transmission
- 4. HIV Transmission Prevention
- 5. Immunology
- 6. HIV Cure Strategies<sup>a</sup>
- 7. HIV Testing and Counseling
- 8. Laboratory Testing Strategies
- 9. The Medical History and Physical Examination of the HIV-Infected Patient
- 10. Initial Laboratory Evaluation and Risk Stratification of the HIV-Infected Patient
- 11. Clinical Syndromes and Differential Diagnosis in the HIV-Infected Patient
- 12. Health Maintenance
- 13. Issues in Specific Patient Populations
- 14. Complementary and Alternative Medicine/Integrative Medicine Approaches
- 15. Care Coordination
- 16. Palliative Care and End-of-Life Support
- 17. HIV Virology
- 18. Principles of Applied Clinical Pharmacokinetics and Pharmacodynamics in Antiretroviral Therapy
- 19. Classes of Antiretrovirals
- 20. Initiation of Antiretroviral Therapy
- 21. HIV-1 Resistance to Antiretroviral Drugs
- 22. Managing the Patient with Multidrug-Resistant HIV
- 23. Future Antiretrovirals, Immune-Based Strategies, and Therapeutic Vaccines
- 24. The Pharmacist’s Role in Caring for HIV-Positive Individuals
- 25. Solid Organ Transplantation in HIV-Infected Individuals
- 26. Antiretroviral Therapy in Pregnant Women
- 27. Antiretroviral Therapy in Children and Newborns
- 28. Immunosuppressants and Antiretroviral Therapy in HIV-Positive Transplant Patients
- 29. Understanding and Managing Antineoplastic and Antiretroviral Therapy
- 30. Substance Abuse in HIV Populations
- 31. Understanding the Use of Antiretroviral Drugs in the Aging Patient
- 32. Opportunistic Infections
- 33. Malignant Diseases in HIV
- 34. Dermatologic Complications
- 35. Endocrine Disorders
- 36. Non-opportunistic Infections
- 37. Psychiatric Illness and Treatment in HIV Populations
- 38. HIV-Associated Neurocognitive Disorders
- 39. HIV/Hepatitis Co-infection
- 40. Ocular Complications
- 41. Cardiovascular Disease
- 42. Renal Complications
- 43. Musculoskeletal Complications of HIV
- 44. Sexually Transmitted Diseases
- 45. HIV and Bone Health
- 46. HIV-Associated Lipodystrophy and Lipoatrophy
- 47. Dyslipidemia
- 48. Immune Reconstitution Inflammatory Syndrome
- 49. US Health Care Systems, HIV Programs, and Coverage Policy Issues
- 50. Legal Issues<sup>a</sup>
- 51. Research Design and Analysis
- 52. Ethical Conduct of Clinical Trials, Institutional Review Boards, Informed Consent, and Financial Conflicts of Interest
- Index