Sep 13, 2000
is this caused by stavudine,efavirenz or didanosine? and what if anything can be done? I was told it's not caused by medication and recently, It has become a (excuse me) pain in my neck, right at the base of my neck.
Response from Dr. Young
Buffalo hump (or dorsocervical adiposity, bison's neck) in HIV-infected is one of the new long-term complications. The actual cause appears to be multi-factorial, and almost definitely not just medications. One of the best studies to address this comes from the CDC's HOPS analysis. In this analysis (and others as well), the risk of the development of this kind of fat abnormality is associated with the age of the person, duration or severity of HIV disease, magnitude of recovery as well as the use of stavudine and indinavir. Importantly, the risks appear to be additive, so that patients whose only risk factors are the HIV treatments have a much lower risk that those with many risk factors.
The treatment of buffalo humps is difficult. Drug switch studies have been disappointing, at least over the short (about 12 month) haul, liposuction is usually associated with recurrence. Serostim (or growth hormone) has shown benefit in those with buffalo humps and/or central adiposity; it's affects also appear to reverse with the cessation of treatment. -BY
Benjamin Young, M.D., Ph.D.
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