Risk factors in the development of human immunodeficiency virus associated-lipodystrophy

Abstract

Introduction: Human immunodeficiency virus associated-lipodystrophy is an important cardiovascular risk factor that develops in 10% to 80% of the cases, impairs quality of life, and reduces adherence to treatment. Its prevention and treatment is of great interest.

Objective: To describe the risk factors that contribute to the development, pathophysiological aspects and treatment of human immunodeficiency virus associated-lipodystrophy.

Methods: A bibliographic search in English and Spanish was conducted. Pubmed, SciELO, Lilacs, Cochrane Library and Web of Science databases were consulted. The search strategy used was: HIV OR AIDS AND lipodystrophy AND adipose tissue AND antiretroviral treatment.

Information, Analysis and Synthesis: Lipodystrophy is characterized by lipoatrophy of the upper and lower limbs, face and buttocks; lipohypertrophy of the visceral, cervical and dorsocervical areas, or a combination of them.  Human immunodeficiency virus proteins make modifications in the gene regulation that inhibits the adipocyte differentiation and increases apoptosis, favored by the systemic inflammatory basal state caused by the virus itself. Antiretrovirals play an important role in the genesis of lipodystrophy.

Conclusions: Female sex, malnutrition, and older ages are some of the main risk factors of the human immunodeficiency virus associated-lipodystrophy, which is influenced by the effects of the virus itself and the antiretroviral therapy. An effective drug treatment is not available, only hygienic-dietary measures and aesthetic surgery are considered.