University of Pittsburgh researcher provides first-ever definition of HIV-associated lipodystrophy

July 19, 2001

PITTSBURGH, July19 - An AIDS researcher from the University of Pittsburgh Graduate School of Public Health (GSPH) today proposed the first definition of HIV-associated lipodystrophy syndrome (HIV-LS)-- the set of physical and metabolic changes that many individuals develop primarily while on HIV drug therapy.

Lawrence Kingsley, Dr. P.H., proposed the definition in Chicago at the 2001 Sessions of the International Association of Physicians in AIDS Care (IAPAC).

"Because there has been no formal definition of the HIV-associated lipodystrophy syndrome up to this point, the prevalence of reported cases of this condition have varied widely -- from less than 10 percent of HIV-infected persons to more than 80 percent," noted Dr. Kingsley, associate professor of infectious diseases and epidemiology at the University of Pittsburgh GSPH. "We are proposing a description of the syndrome that can guide physicians and other health care providers in properly diagnosing their patients."

HIV-LS involves changes in fat distribution throughout the body, along with cholesterol and glucose abnormalities, in HIV-infected individuals taking highly-active antiretroviral therapy (HAART) or antiretroviral therapy (ART), and in some people who are not on drug therapy but who have long-term HIV infection. The body-shape changes experienced by patients are dramatic and anxiety provoking, while the changes in lipids and glucose metabolism may increase their long-term risk of cardiovascular disease.

Signs of HIV-LS are a wasting, or a reduction in fat (lipoatrophy), in the face, arms, legs and buttocks; and an increase in fat (lipodystrophy) in the abdomen, back of the neck and breasts. The added abdominal fat is primarily visceral fat, which accumulates within the abdominal cavity, around the organs.

Dr. Kingsley's proposed definition of HIV-LS follows:

1. Peripheral Lipoatrophy only -- moderate or greater subcutaneous fat loss in two or more of the following areas: arms, legs, buttocks or face scored as mild, moderate or severe.

2. "Mixed" Lipodystrophy -- peripheral lipoatrophy (see 1. above) plus moderate or greater increased fat accumulation in the abdomen or breasts, with or without additional fat at the back of the neck.

3. Peripheral Lipoatrophy or Mixed Lipodystrophy along with metabolic abnormalities of glucose metabolism or lipids.

In monitoring HIV-infected individuals every three to six months, Dr. Kinglsey suggests that health care providers keep track of changes in height, weight, body-mass index, arm, thigh, waist, hip and waist-to-hip ratio using the standardized protocol.

Dr. Kingsley recommends dual energy X-ray absorptiometry (DEXA) scan for quantifying muscle, bone and fat in arms, legs and abdomen, and computed tomography (CT) or MRI to quantify and discriminate between visceral and subcutaneous fat.

In addition, Dr. Kingsley recommends the following fasting blood tests for metabolic abnormalities: cholesterol (total, HDL and LDL), triglycerides, HBA1c, glucose, insulin, apolipoprotein A and B, and lipoprotein A.

Dr. Kingsley's recommendations are based on clinical information gathered through the Multicenter AIDS Cohort Study (MACS), a National Institutes of Health-funded epidemiological study of HIV infection in homosexual men. The University of Pittsburgh GSPH is one of four sites nationwide participating in the MACS. Dr. Kingsley is co-principal investigator of the Pittsburgh-site, known locally as the Pitt Men's Study. MACS is currently in its 16th year of surveying the natural history of HIV.
Additional Contact:
Jocelyn Uhl
PHONE: 412-624-2607
FAX: 412-624-3184

University of Pittsburgh Medical Center

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to