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Can advanced aging in HIV cause kyphosis?
May 19, 2013

I am a 42 year old asymptomatic Hiv+ man and suddenly I have developed a fat deposit at the base of the back of my neck. My doctor has ruled out lipodystophy and calls it dowagers hump. Is it possible advanced aging with Hiv is the cause of this at 42?

Response from Dr. Young

Hello and thanks for posting your interesting question.

I'll assume that your doctor has made the correct diagnosis- that your neck curvature isn't lipodystrophy but rather a "dowager's hump". The later is actually a manifestation of bony problems of the spine.

This can be because of trauma (though I'd suspect that you would have mentioned this) or because of compression fractures. In the negative population, fractures are most commonly associated with osteoporosis- and indeed our research with the CDC indicates that when matched for age and gender, HIV+ers are at significantly greater risk of such fractures.

Osteoporosis and bone health is an area of growing concern for HIV care providers. At a minimum, it's probably a good thing to have a bone mineral density scan (called a DEXA), have your kidney function and vitamin D levels checked. Avoidance of tobacco and getting adequate amounts of weight-bearing exercise and dietary calcium and vitamin D are also help prevent (or treat) the condition. For more about osteoporosis, take a peek at myhivclinic.org.

Be well, and feel free to write back with any follow up questions. BY



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