The Body Covers: The First International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV
Reaching a Consensus -- Lipodystrophy Case Definition
June 28, 1999
Chairs: Andrew Carr, Stefan Mauss, and Kathleen Mulligan
Various attendees at this meeting had group discussion sessions on fat wasting, fat accumulation, lipid disturbances, glucose disturbances and miscellaneous manifestations associated with lipodystrophy syndrome in HIV patients. The summaries of these group discussion sessions were presented to all attendees to evolve a lipodystrophy case definition.
The following consensus emerged from the meeting. First, the diagnosis of lipodystrophy in HIV patients should be based on confirmation of patient's self report by the clinician or by clinician's observations alone. Second, the prominent features of fat loss associated with lipodystrophy were buccal (cheek) fat loss, gluteal (buttocks) fat loss and prominent, non-varicose veins in the legs. Fat accumulation can be noted in the trunk resulting in increased abdominal girth. Breast hypertrophy, buffalo hump (on the back of neck), lipomas and increased facial fat can also occur in some patients. These findings are associated with abnormalities in glucose and lipid metabolism.
It was recognized that there might be more that one syndrome of lipodystrophy in HIV patients. There may be other clinical features and laboratory findings of the lipodystrophy syndrome in HIV patients that have not yet been recognized. Further information needs to be collected about the role of gender, age, race, baseline adiposity, types and duration of therapy in development of the lipodystrophy syndrome. A plan was discussed to collect a multitude of data from various sites about the lipodystrophy syndrome in order to come up with a refined definition at a later date.
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