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Lipodystrophy and WastingLipodystrophy and Wasting
          
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Causes of lipodystrophy?
Mar 8, 2003

Are the different types of lipodystrophy regarding body changes induced by different aspects? Because there is the thinning of legs, arms and face which could remind one of the effect of the virus itself near terminal stages and which can happen with transcriptase inhibitors regimes, which does not make much sense if you think of the amount of people that take them and do not go to such extremes. And there is the belly, bust and neck symptoms which clearly happen with protease inhibitors regardless of your previous stage, age, body shape etc. How much is the virus, how much are the medicines, doesn't any body know exactly what causes it? They say it is irreversible and I am not too sure about it, as I know by experience that if it has not gone too far you can overcome it. Have you ever seen a case of harsh body changes that has overcomed it? How did they do it? And can you sincerely say that it is a question researched enough and there is no possibility of solving it in reasonable time? Thank you for your time. Female positive.

Response from Ms. Fields-Gardner

What we "know" at this point in time are some of the risk factors associated with the development of body changes and metabolic changes in chronic HIV infection. There are apparently several different manifestations. In my experience there are quite a few ways people show changes and different bodies seem to react differently. So, there are likely to be a number of factors that predispose a person to changes or to resist changes. Though it is not "known" how much each factor contributes to changes in all people with chronic HIV infection, it is likely that there are a number of interactions and host factors (genetic predisposition, diet, exercise, smoking, drinking, etc) that influence the appearance and maybe even the severity of the problem.

I don't think that it is yet assumed that the problem is irreversible because there are a few research trials going on and planned to look at therapies to slow, stop, and reverse these problems. I have seen some improvements in different individuals, but each of them made different changes in their circumstances so it is difficult to pin one item down. Changes that have been made include changes in diet, exercise, smoking, drinking, medications, and treatment for hormonal imbalances. Some chose surgical interventions.

You ask if this question is researched enough. The answer has to be "no" because we don't know enough yet to prevent and treat individuals with assured success. I think that we will learn a great deal that we can transfer to many other disease states, which makes it even more important to discover how the problems occur and how they can be reversed (and what the impact of reversal really is).


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