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Causes of Buffalo hump
Jun 24, 2004

Hi Dr.

I'm have been poz since 1999 and very healthy. Currently I'm taking Viread,Epivir, and Viramune with testosterone replacement therapy. Recently I'm seeing a small hump developing in the center of my lower neck area. I work out regularly and friends think it's muscle. I'm not convinced. What are the causes of BH. Am I stressing for nothing-it feels hard not at all like fatty tissue? Thank You for your time. Paul

Response from Dr. Conway

The posterior cervical fat pad (if this is what it is) can occur with HIV infection without any treatment, but this is much less usual. It occurs more often on treatment, with the most common associations being with stavudine and protease inhibitors (less with atazanaivr and nelfinavir).

It is important to remember that it occurs with certain hormone imbalances such as Cushing's disease (excess cortisol) and you should discuss this with your doctor. Finally, iw oudl ask if it was there before you were on testosterone and whether you are taking the testosterone due to a proven testoterone deficiency or for some other reason. If it is the latter, I may ask if you would consider stopping to see how it goes.

Many possibilities...

Kaletra and Lypodystrophy? Drug Holiday?

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