The exact mechanism of HIV-associated lipodystrophy is not fully elucidated. There is evidence indicating both that it can be caused by anti-retroviral medications and that it can be caused by HIV infection in the absence of anti-retroviral medication.
On the other hand, there is evidence that HIV-1 infection on its own contributes to the development of the lipodystrophic phenotype by interfering with some key genes of adipocyte differentiation and mitochondrial function on patients which have not received antiretroviral treatment.
HIV-associated lipodystrophy commonly presents with fat loss in face, buttocks, arms and legs.
There is also fat accumulation in various body parts. Patients often present with "buffalo hump"-like fat deposits in their upper backs. Breast size of patients (both male and female) tends to increase. In addition, patients develop abdominal obesity.
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^ abMartinez E, Mocroft A, García-Viejo MA et al. (February 2001). "Risk of lipodystrophy in HIV-1-infected patients treated with protease inhibitors: a prospective cohort study". Lancet357 (9256): 592–8. doi:10.1016/S0140-6736(00)04056-3. PMID11558485.CS1 maint: Explicit use of et al. (link)
^Giralt M, Domingo P, Guallar JP et al. (2006). "HIV-1 infection alters gene expression in adipose tissue, which contributes to HIV- 1/HAART-associated lipodystrophy.". Antivir Ther11 (6): 729–40. PMID17310817.CS1 maint: Explicit use of et al. (link)
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