Identifying and managing morphologic complications of HIV and HAART.

Morphologic complications continue to be observed in patients receiving HAART. Body habitus changes include fat accumulation, lipoatrophy, and HIV-associated wasting. Anthropometry, dual-energy x-ray absorptiometry, and imaging methods (CT, MRI) are most useful for detecting fat redistribution syndromes, while bioelectric impedance analysis is useful for determining and monitoring wasting. Various clinical interventions, including diet and exercise, switching antiretroviral agents, the use of lipid-lowering and insulin-sensitizing agents, recombinant human growth hormone therapy, and plastic surgery, are under investigation for the treatment of morphologic changes. Prospective, controlled clinical trials are needed to determine the long-term efficacy of these approaches.