Treatment options for lipodystrophy in HIV-positive patients.

The HIV-associated lipodystrophy syndrome is one of the major side effects of HIV-therapy. Its metabolic abnormalities may harbor a significant risk for cardiovascular disease with as yet unknown consequences. Present data indicate a rather multifactorial pathogenesis where HIV infection, its therapy and patient-related factors are major contributors. Therapeutic interventions in patients with lipodystrophy have so far been of only limited success in many cases. General recommendations include dietary changes and lifestyle modifications, altering antiretroviral drug therapy (substitution of stavudine and zidovdine with e.g., abacavir or tenofovir or replacement of protease inhibitors with non-nucleoside reverse-transcriptase inhibitors), and finally, the use of metabolically active drugs. Here, the treatment options of the HIV-lipodystrophy syndrome are summarized based on the present literature.