What is lipodystrophy?

Lipodystrophy refers to the changes in body fat that affect some people with HIV.Some patients suffering from HIV often have fat loss in their face which can lead to a hollow, gaunt, and sickly look even in patients otherwise still healthy. They can suffer severe lipoatrophy in the face, particularly in the temples (temporal hollowing) accentuating the zygomatic arch between the eye and ear. Good news is not all HIV patients  will develop lipodystrophy.

What causes lipodystrophy?

The exact cause of lipodystrophy is unknown. It may be due to HIV infection or medicines used to treat HIV. Although more research is needed to prove that there is a link between HIV medicines and lipodystrophy, some HIV medicines have been associated with the condition. Newer HIV medicines are less likely to cause lipodystrophy than HIV medicines developed in the past.

Other risk factors for lipodystrophy include:

  1. Age: Older people are at higher risk.
  2. Race: Whites have the highest risk.
  3. Gender: Men are more likely to have fat loss in the arms and legs. Women are more likely to have buildup of breast and abdominal fat.
  4. Length and severity of HIV infection: The risk is higher with longer and more severe HIV infection.

How is lipodystrophy treated?

There are several ways to manage lipodystrophy:

  1. A healthy diet and daily exercise may help to build muscle and reduce fat buildup.
  2. Liposuction (surgical removal of fat) is sometimes used to reduce a buffalo hump. Fat or a fat-like substance can be used as a filler for fat loss in the face. The filler is injected in the cheeks or around the eyes and mouth.
  3. Dermal fillers such as Metacrill which is an injectable filler made up of PMMA microspheres are often used to treat fat loss secondary to HIV. Lost facial fat is very slow to recover. Instead, many patients choose to undergo cosmetic treatments to help the condition. While the different symptoms of lipodystrophy are treated in different ways, facial wasting can be addressed and treated using cosmetic fillers. These cosmetic fillers are often covered by Medicare and Medicaid, and by many private insurance carriers, depending on the situation.