Lipodystrophic syndrome and antiretroviral treatments in HIV-infected patients

Lipodystrophy. syndrome is characterised by either fat loss in face or I li mbs or fat accumulation in the posterior neck, breast or abdomen. Although rare in other populations, it may occur in up to 70 % of HIV-infected patie nts receiving a protease inhibitor-containing antiretroviral regimen. Morph ologic. changes are often associated with dyslipidemia and insulin-resistan ce. Pathophysiologic hypotheses underlying this 1 condition, suggest either an homology between protease inhibitor receptors and proteins involved, in the lipid metabolism, or a dysregulation of the mitochondria. which may ex plain a link with nucleosides; analogues. Host factors remain however impor tant to explain the variability of prevalence. The onset of such morphologi cal or laboratory changes may influence the adherence to antiretroviral tre atments. Long-term effects have not been yet well-described, although an in crease of cardiovascular diseases is suspected. Finally, the definition of the syndrome remains to be established, as well as its mechanisms, evolutio n and consequences. Current case management includes attention to symptoms and prevention of cardio-vascular disease.