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Metabolic
Syndrome News
We know lipodystrophy
syndrome (LDS) is a complication of HAART in HIV-positive adults and children.
For background information, readers of this article may refer to previous
HIV
ReSource Review and HIV Nutrition Update newsletter issues along with
our free weekly HIV Nutrition News Update archives with highlights of research
on LDS at Archive 1
, Archive 2
and Archive 3. |
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Impact And Detection of
LDS
Sattler reminds us that
changes in body fat associated with HAART range from 20% to 80%. (1) Loss
of characteristic appearance is common with reduction of facial fat most
likely to carry the greatest stigma for people with HIV/AIDS. (2) Although
the most significant treatment-related factor may be duration of antiretroviral
therapy, host factors such as older age and lower pretherapy body mass
index may be more important than the choice of antiretrovirals in the development
of LDS. (3) Results
from a prospective multinational cohort study (DAD study started in
1999) associated the use of both non-nucleoside reverse transcriptase inhibitors
and protease inhibitors (PIs), particularly among older individuals with
normalized CD4 cell counts and suppressed HIV replication, with a lipid
profile known to increase the risk of heart disease.
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Korean investigators
conducting preliminary studies reported that LDS is a rare metabolic complication
of HAART in an oriental HIV-positive group of individuals. (4) Spanish
investigators note the impact of LDS on quality of life may depend on certain
patient characteristics such as homosexuality, unemployment, and psychiatric
treatment. (5) Although the presence of LDS does not seem to influence
the attitude toward individual health condition and the feeling of well-being,
patients are more likely to feel recognizable as HIV-positive by their
physical appearance. (2) Other preliminary studies show that adherence
to therapy may be affected as individuals with LDS have bodily discomfort,
low self esteem and depression along with social isolation. (6) Besides
collagen injections to the face, which may be temporary, individuals may
make changes in diet, exercise regimens and steroid use.
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2/1/2004
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