Lipodystrophy

Lisa A. Spacek, M.D., Ph.D.
Lipodystrophy is a topic covered in the Johns Hopkins HIV Guide.

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CLINICAL

  • Lipodystrophy: changes in body fat composition based on anthropomorphic measures of fat distribution such as waist circumference.
    • Accompanied by metabolic disorders: dyslipidemia, hypertriglyceridemia, low HDL, insulin resistance, and DM.
    • Associated with long-term use of some ARV regimens.
  • Lipohypertrophy (LH) or fat accumulation (FA): central visceral fat gain, increased breast fat, and dorsocervical fat pad ("Buffalo hump").
    • Central adiposity linked to higher mortality.[6]
    • Associated with elevation of inflammatory cytokines.
  • Lipoatrophy (LA): peripheral fat loss in face, limbs and buttocks.
    • Consequence of thymidine analog NRTIs: d4T, ZDV. Switching ART prevents progression, but fat recovery slow and likely incomplete.
    • Can be confused with wasting, which is due to HIV disease progression and/or OIs, and includes both muscle and fat loss.

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Last updated: February 1, 2015