Lipodystrophy in HIV patients: its challenges and management approaches

Rohit Singhania, Donald P KotlerDepartment of Medicine, St Luke&#39;s-Roosevelt Hospital Center, New York, NY, USAAbstract: HIV-associated lipodystrophy is a term used to describe a constellation of body composition (lipoatrophy and lipohypertrophy) and metabolic (dyslipidemia and insulin re...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Singhania R, Kotler DP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/c35a92d4cd4c4daf904767d83e9f1d59
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c35a92d4cd4c4daf904767d83e9f1d59
record_format	dspace
spelling	oai:doaj.org-article:c35a92d4cd4c4daf904767d83e9f1d592021-12-02T02:33:37ZLipodystrophy in HIV patients: its challenges and management approaches1179-1373https://doaj.org/article/c35a92d4cd4c4daf904767d83e9f1d592011-12-01T00:00:00Zhttp://www.dovepress.com/lipodystrophy-in-hiv-patients-its-challenges-and-management-approaches-a8865https://doaj.org/toc/1179-1373Rohit Singhania, Donald P KotlerDepartment of Medicine, St Luke&#39;s-Roosevelt Hospital Center, New York, NY, USAAbstract: HIV-associated lipodystrophy is a term used to describe a constellation of body composition (lipoatrophy and lipohypertrophy) and metabolic (dyslipidemia and insulin resistance) alterations that accompany highly active antiretroviral therapy. These changes, which resemble metabolic syndrome, have been associated with a variety of adverse outcomes including accelerated cardiovascular disease. The body composition and metabolic changes appear to cluster in HIV infection, although they are distinct alterations and do not necessarily coexist. Epidemiological studies have demonstrated multiple pathogenic influences associated with host, disease, and treatment-related factors. The adverse treatment effects were more prominent in early regimens; continued drug development has led to the application of metabolically safer regimens with equal or greater potency than the regimens being replaced. Disease-related factors include HIV infection as well as inflammation, immune activation, and immune depletion. The body composition changes promote anxiety and depression in patients and may affect treatment adherence. Treatment of dyslipidemia and alterations in glucose metabolism is the same as in non-HIV-infected individuals. Lipoatrophy is managed by strategic choice of antivirals or by antiviral switching, and in some cases by plastic/reconstructive surgery. Lipohypertrophy has been managed mainly by lifestyle modification, ie, a hypocaloric diet and increased exercise. A growth hormone releasing factor, which reduces central fat, has recently become available for clinical use.Keywords: lipoatrophy, lipohypertrophy, body composition, dyslipidemia, insulin resistanceSinghania RKotler DPDove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2011, Iss default, Pp 135-143 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Singhania R Kotler DP Lipodystrophy in HIV patients: its challenges and management approaches
description	Rohit Singhania, Donald P KotlerDepartment of Medicine, St Luke&#39;s-Roosevelt Hospital Center, New York, NY, USAAbstract: HIV-associated lipodystrophy is a term used to describe a constellation of body composition (lipoatrophy and lipohypertrophy) and metabolic (dyslipidemia and insulin resistance) alterations that accompany highly active antiretroviral therapy. These changes, which resemble metabolic syndrome, have been associated with a variety of adverse outcomes including accelerated cardiovascular disease. The body composition and metabolic changes appear to cluster in HIV infection, although they are distinct alterations and do not necessarily coexist. Epidemiological studies have demonstrated multiple pathogenic influences associated with host, disease, and treatment-related factors. The adverse treatment effects were more prominent in early regimens; continued drug development has led to the application of metabolically safer regimens with equal or greater potency than the regimens being replaced. Disease-related factors include HIV infection as well as inflammation, immune activation, and immune depletion. The body composition changes promote anxiety and depression in patients and may affect treatment adherence. Treatment of dyslipidemia and alterations in glucose metabolism is the same as in non-HIV-infected individuals. Lipoatrophy is managed by strategic choice of antivirals or by antiviral switching, and in some cases by plastic/reconstructive surgery. Lipohypertrophy has been managed mainly by lifestyle modification, ie, a hypocaloric diet and increased exercise. A growth hormone releasing factor, which reduces central fat, has recently become available for clinical use.Keywords: lipoatrophy, lipohypertrophy, body composition, dyslipidemia, insulin resistance
format	article
author	Singhania R Kotler DP
author_facet	Singhania R Kotler DP
author_sort	Singhania R
title	Lipodystrophy in HIV patients: its challenges and management approaches
title_short	Lipodystrophy in HIV patients: its challenges and management approaches
title_full	Lipodystrophy in HIV patients: its challenges and management approaches
title_fullStr	Lipodystrophy in HIV patients: its challenges and management approaches
title_full_unstemmed	Lipodystrophy in HIV patients: its challenges and management approaches
title_sort	lipodystrophy in hiv patients: its challenges and management approaches
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/c35a92d4cd4c4daf904767d83e9f1d59
work_keys_str_mv	AT singhaniar lipodystrophyinhivpatientsitschallengesandmanagementapproaches AT kotlerdp lipodystrophyinhivpatientsitschallengesandmanagementapproaches
_version_	1718402436274585600

Lipodystrophy in HIV patients: its challenges and management approaches

Ejemplares similares