A Novel Pattern of Lipoaccumulation in HIV-Infected Men
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To the Editor: Body habitus changes among persons infected with human immunodeficiency virus (HIV) who receive highly active antiretroviral therapy (HAART) are major concerns, in part because of their frequent association with insulin resistance and hyperlipidemia. The desire to avoid such changes has influenced selection of antiretrovirals and timing of HAART initiation. Lipoatrophy is of particular cosmetic concern to affected individuals. It is most commonly manifested as limb and gluteal fat loss with consequent apparent thinning of the extremities and facial fat loss with a "sunken cheek" appearance.1-2 Lipoaccumulation most often appears as visceral abdominal adiposity with increased abdominal girth. Other manifestations include dorsocervical fat pads ("buffalo humps") and neck lipoaccumulation ("bull neck").
We report what we believe to be a novel manifestation of lipoaccumulation in 8 men with HIV infection.
Methods
All individuals are HIV-infected participants in the Multicenter AIDS Cohort Study (MACS), a longitudinal study of men who have . . . [Full Text of this Article]
Frank J. Palella, Jr, MD
f-palella@northwestern.edu
Joan S. Chmiel, PhD
Feinberg School of Medicine
Northwestern University
Chicago, Ill
Sharon A. Riddler, MD;
Bridget Calhoun, PA, MPH
University of Pittsburgh School of Medicine
Pittsburgh, Pa
Adrian Dobs, MD
Johns Hopkins University Medical School
Baltimore, Md
Barbara Visscher, MD, DrPH
University of California at Los Angeles College of Medicine
Los Angeles
Lawrence Kingsley, DrPH
University of Pittsburgh Graduate School of Public Health
Pittsburgh, Pa
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