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Lipodystrophy and WastingLipodystrophy and Wasting
           
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is "Buffalo Hump" reversable ?
Oct 12, 2003

I understand that switching from zerit to ziagen or viread may help to gain back lost fat. Does it help to lose fat gained in unwanted places such as upper back and neck ?

Response from Dr. Moyle

There have been so few people in the studies that have looked at switching, that it is not possible to get a realistic idea about whether buffalo humps improve after treatment switching from d4T to abacavir. Anecdotally, I have seen some modest improvements but rarely have I seen complete resolution even after a year or more of observation. I suspect, that in part this is related to the fact that buffalo humps may be more linked with insulin resistance, something which may not improve so dramatically after nucleoside analog modification. Some individuals receiving growth hormone have reported an improvement in this size and firmness of buffalo humps however there appears to be some recurrence of the problem after growth hormone is discontinued. Another approach may need to use insulin sensitising agents such as metformin or rosiglitazone. Again information on the use of these drugs is anecdotal rather than factual. Finally, if none of these approaches work or the buffalo hump is so large that it is obvious or uncomfortable for you surgical debulking is always an option but obviously will leave a scar and may not necessarily eliminate the possibility that the buffalo hump may partially recur.

I hope this helps

best wishes

Graeme Moyle.


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