Lipodystrophy and metabolic changes
Lipodystrophy refers to changes in fat cells and the distribution of body fat. It also refers to changes in blood fat and blood sugar levels (metabolic changes).
We do not know what causes all these changes, which usually, but not always, develop slowly over many months.
Yet, this is one of the biggest worries for people who are about to start treatment.
- The greater awareness of lipodystrophy means that you will be monitored carefully.
- If you have worries, make sure your doctor takes them seriously and does something about it.
Fat loss (from arms, legs, face and buttocks) is linked to two drugs – d4T and AZT. As these drugs are less used in first-line therapy, fat loss is rare.
Fat accumulation to the stomach or breasts and/or across the shoulders or neck has been linked to combinations that include protease inhibitors and NNRTIs.
Mild symptoms may reverse if you switch to different HIV drugs. Exercise and dietary changes can also help.
Changes in fat (cholesterol and triglyceride) and sugar (glucose) levels are linked to many drugs and will be monitored by routine blood and/or urine tests.
Diet, exercise, changing treatment or using lipid lowering drugs are all options.