HIV-associated lipodystrophy

The fatFat redistribution syndrome (or HIV lipodystrophy syndrome) is seen in a number of AIDS patients on HAART. It is characterised by typical changes in body fat distribution.

Pathology

Biochemically, these patients have increased triglycerides, total cholesterol, low-density lipoprotein-cholesterol, and extremely low high-density lipoprotein-cholesterol.

Radiographic features

Features of fat redistribution syndrome are the same in different modalities and include :

• hypertrophy in the neck fat pad (buffalo hump)
• increased fat in the abdominal region (protease paunch)
• gynecomastia
• loss of fat in the midface and extremities.

Treatment and prognosis

Complications

If left untreated, these patients develop and die of complications of metabolic origin such as cardiovascular diseases or diabetes mellitus. Biochemical features manifest before the clinical pictures become apparent.

Differential diagnosis

For hypertrophy of the fat around the neck consider:

• Madelung disease
• obesity
• steroid use