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Percentages chance of lipo.?
Jan 5, 2007

Hello, I know this is not a question to which you can provide a definitive answer, but to all of us anxious HIVers, maybe a guide would be helpful. Diagnosed 2 years now, CD4 32, VL >m, but now CD4 366 and VL <40 (so, doing well) but I live in a state of constant anxiety about my future. Not about becoming ill - I am very well, but about things like resistance, treatment failure and of course,lipodystrophy. For me, this is the most worrying element to my 'condition'. My question is: in your opinion, (and I know there can be no definitive answer) what percentage of us WILL go on to develop lipo.? And at what stage? I have no sign now, but will I in the future? How likely? (Truvada and Efavirenz, no miseed doses). Please help...me and ALL of us to whom this is a daily fear. Thanks for the terrific work you do, Best regards, NB (U.K)

Response from Dr. Pierone

Hello, and thanks for posting.

In my opinion the percentage of patients who will go on to develop lipodystrophy is about 10 to 20%.

The two general categories of lipodystrophy are lipoatrophy and lipohypertrophy.

Lipoatrophy, especially facial lipoatrophy is the most evident form of this condition. This can give the appearance of chronic illness due to the loss of facial fat. The risk of developing this problem is much lower with newer regimens like yours, and we should see less over time as clinicians prescribe less AZT and Zerit (in the developed world at least).

Lipohypertrophy is abdominal protuberance due to accumulation of visceral adipose tissue and is more closely tied in with protease inhibitor exposure. This condition is not specific to HIV and some people have a genetic tendency to accumulate fat in the visceral compartment.

Some of the newer agents, integrase inhibitors in particular, appear to be less likely to produce lipodystrophy, at least based on the early data.



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