Fuller Jon
Boston University School of Medicine, and Center for HIV/AIDS Care and Research, Boston Medical Center, Boston, Massachusetts 02118, USA.
JAMA. 2008 Sep 3;300(9):1056-66. doi: 10.1001/jama.300.5.jrr80007. Epub 2008 Aug 3.
Human immunodeficiency virus (HIV)-associated lipodystrophy refers to fat accumulation, also known as lipohypertrophy, and fat wasting, also known as lipoatrophy. Both conditions can be very disturbing to patients and have been associated with metabolic disturbances such as insulin resistance and hyperlipidemias. The prevalence of HIV-associated lipodystrophy ranges from 6% to 69% in the medical literature. Although no clear associations have been made between specific drugs and HIV lipohypertrophy, stavudine and zidovudine have been implicated in the development of HIV lipoatrophy. The case of Mr B, a 39-year-old man with HIV-associated lipodystrophy whose facial changes are a cause of significant distress, highlights the need for clinicians to be attuned to the psychological impact that lipodystrophy can have on patients, especially because it may serve as a disincentive to adherence to antiretroviral drug regimens, resulting in an increased risk of developing viral resistance.
人类免疫缺陷病毒（HIV）相关脂肪代谢障碍是指脂肪堆积，也称为脂肪增生，以及脂肪消耗，也称为脂肪萎缩。这两种情况都可能给患者带来很大困扰，并且与代谢紊乱有关，如胰岛素抵抗和高脂血症。在医学文献中，HIV相关脂肪代谢障碍的患病率在6%至69%之间。虽然尚未明确特定药物与HIV脂肪增生之间的关联，但司他夫定和齐多夫定被认为与HIV脂肪萎缩的发生有关。B先生是一名39岁患有HIV相关脂肪代谢障碍的男性，其面部变化给他带来了极大困扰，这一案例凸显了临床医生需要关注脂肪代谢障碍对患者可能产生的心理影响，特别是因为它可能成为患者坚持抗逆转录病毒药物治疗方案的阻碍，从而增加产生病毒耐药性的风险。
