[HIV-lipodystrophy syndrome].

CLINICAL FINDINGS

The HIV-associated lipodystrophy syndrome is reported with an increasing incidence predominantly in HIV-seropositive patients on antiretroviral therapy. The core of the lipodystrophy syndrome consists of fat loss in face, extremities and buttocks with or without a visceral fat accumulation, hyperlipidemia and a disturbed glucose metabolism are considered essential parts of the syndrome too. Additional metabolic abnormalities are regarded as syndrome related.

PATHOGENESIS

Currently identified risk factors associated with the development of lipodystrophy are antiretroviral treatment (duration, number and kind of drugs), low CD4 cell count, higher age and metabolic abnormalities. The currently favored hypotheses to explain the lipodystrophy syndrome are essentially based on the assumption that antiretroviral treatment is the cause of the disorder.

TREATMENT

The short-term benefit of antiretroviral treatment is greater than the disadvantages of the lipodystrophy syndrome, in the long term, however, the cardiovascular risk associated with the metabolic disturbances may result in an increased mortality on its own. The current approach to treatment includes modification of antiretroviral therapy and specific treatment of symptoms.