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Is it possible to have lipodystrophy and still be a slow or non-progessor?
Feb 25, 2010

Dr. McGowan,

I had a possible HIV exposure in 2003 although I do not know if the person had HIV. I'm a straight, 35 year old male.

Since then I've been tested a total of 11 times for HIV, three times six years after possible exposure and still negative.

Yet signs of lipodystrophy are present, and I've been diagnosed with low testosterone recently. So pointers are there for HIV. It's sort of frustating, like having your arm fall off and then someone saying, no your arm is fine, it's all in your head.

My question is could someone have HIV and have lipodystrophy/atrophy and yet be considered a slow or non-progessor because they're immune system is still doing really well? Like could HIV affect the system metabolically but not cause serious health problems?

My last HIV tests were Sept. 2009 and then Dec.2009 Antibody - Negative Antibody - Negative PCR RNA to 48 Copies - Negative

CD4 Count in 2003 was 1000, in Nov. 2009 it was 701 and in Feb. 2010 it was 1202.

Thanks Dr. McGowan!

M.

Response from Dr. McGowan

There are many reasons people may develop lipodystrophy. Sometimes it is part of normal aging, sometimes it may be due to hormone imbalance. The latter may be the cause in your case. Not all hormone imbalance or low testosterone is caused by HIV, in fact the vast majority of cases have nothing to do with HIV. Also, persons who are long-term non-progressors with HIV, or even "elite controllers" who may have undetectable viral loads off trteatment will test HIV positive on screening. Their immune systems are revved up to supppress the virus. Your negative HIV antibody tests prove that you are not in this group.

You should speak with your doctor about having an endocrine (hormone) evaluation.

Best, Joe



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