HIV-associated lipodystrophy
Encyclopedia
HIV-associated lipodystrophy is a condition characterized by loss of subcutaneous fat associated with infection with HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

.

Cause

The exact mechanism of HIV-associated lipodystrophy is not fully elucidated. There is evidence indicating both that it can be caused by anti-retroviral medications and that it can be caused by HIV infection in the absence of anti-retroviral medication.

Evidence implicating anti-retroviral medications

On the one hand, lipodystrophy seems to be mainly due to HIV-1 protease inhibitors. Interference with lipid metabolism
Lipid metabolism
Lipid metabolism refers to the processes that involve the intercourse and degradation of lipids.The types of lipids involved include:* Bile salts* Cholesterols* Eicosanoids* Glycolipids* Ketone bodies* Fatty acids - see also fatty acid metabolism...

 is postulated as pathophysiology. Also, the development of lipodystrophy is associated with specific nucleoside reverse transcriptase inhibitors (NRTI). Mitochondrial toxicity
Mitochondrial toxicity
Mitochondrial toxicity is a condition in which the mitochondria of a body's cells become damaged or decline significantly in number; it occurs as a side effect of certain antiretroviral drugs used to treat human immunodeficiency virus, or HIV.-Causes:...

 is postulated to be involved in the pathogenesis associated with NRTI.

Evidence implicating HIV infection alone

On the other hand, there is evidence that HIV-1 infection on its own contributes to the development of the lipodystrophic phenotype by interfering with some key genes of adipocyte differentiation and mitochondrial function on patients which have not received antiretroviral treatment.

Presentations include

HIV-associated lipodystrophy commonly presents with fat loss in face, buttocks, arms and legs.

There is also fat accumulation in various body parts. Patients often present with "buffalo hump"-like fat deposits in their upper backs. Breast size of patients (both male and female) tends to increase. In addition, patients develop abdominal obesity.

See also

  • Lipodystrophy
    Lipodystrophy
    Lipodystrophy is a medical condition characterized by abnormal or degenerative conditions of the body's adipose tissue. A more specific term, lipoatrophy is used when describing the loss of fat from one area...

  • Drug-induced lipodystrophy
    Drug-induced lipodystrophy
    Drug-induced lipodystrophy is a cutaneous condition that presents as one or multiple depressed areas , usually on the proximal extremities, ranging from under a few centimeters to greater than 20 cm in diameter.- See also :...

  • List of cutaneous conditions
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