Managing HIV lipoatrophy

Abstract

Treatment with multidrug antiretroviral regimens dramatically reduces HIV-associated morbidity and mortality. However, prolonged therapy can be complicated by a range of adverse effects, including the metabolic syndrome (dyslipidaemia, insulin resistance, visceral adiposity) and subcutaneous lipoatrophy—collectively called lipodystrophy. The morphological changes of lipodystrophy are highly stigmatising and can cause discomfort, disability, psychological morbidity, and reduced adherence or discontinuation of otherwise effective antiretroviral therapy. The metabolic changes contribute to an increased risk of cardiovascular events. No effect of rosiglitazone for treatment of HIV-1 lipoatrophy: randomised, double-blind, placebo-controlled trialRosiglitazone for 48 weeks did not improve lipoatrophy in HIV-1-infected adults receiving antiretroviral therapy. Use of less toxic antiretroviral treatment is necessary to prevent lipoatrophy. Full-Text PDF