The HIV-associated lipodystrophy syndrome

Clinical Findings: The HIV-associated lipodystrophy syndrome is reported wi th an increasing incidence predominantly in HIV-seropositive patients on an tiretroviral therapy. The core of the lipodystrophy syndrome consists of fa t loss in face, extremities and buttocks with or without a visceral fat acc umulation, hyperlipidemia and a disturbed glucose metabolism are considered essential parts of the syndrome too. Additional metabolic abnormalities ar e regarded as syndrome related. Pathogenesis: Currently identified risk factors associated with the develop ment of lipodystrophy are antiretroviral treatment (duration, number and ki nd of drugs), low CD4 cell count, higher age and metabolic abnormalities. T he currently favored hypotheses to explain the lipodystrophy syndrome are e ssentially based on the assumption chat antiretroviral treatment is the cau se of the disorder. Treatment: The short-term benefit of antiretroviral treatment is greater th an the-disadvantages of the lipodystrophy syndrome, in the long term, howev er, the cardiovascular risk associated with the metabolic disturbances may result in an increased mortality on its own. The current approach to treatm ent includes modification of antiretroviral therapy and specific treatment of symptoms.