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HIV1 protease inhibitor lipodystrophy

A lipodystrophy syndrome resulting from therapeutic use of antiretroviral protease inhibitors in the treatment of patients with AIDS. Etiology: - antiretroviral protease inhibitors - zidovudine Pathology: - thought to be secondary to inhibition the low-density lipoprotein (LDL) receptor related protein (LRP) Clinical manifestations: 1) central visceral redistribution of fat 2) wasting of extremities 3) hyperlipidemia 4) insulin resistance Management: - statins of limited (if any) benefit [1] - metformin & statin therapy for patients with insulin resistance & hyperlipidemia [2] - tesamorelin can reduce fat accumulation but does not treat insulin resistance or hyperlipidemia [2]

Related

CD91, low density lipoprotein (LDL) receptor related protein (LRP) 1, apolipoprotein E [apoE] receptor 1, chylomicron remnant receptor or alpha-2 macroglobulin receptor HIV1 infection; human immunodeficiency virus-1 infection protease inhibitor

General

lipodystrophy; lipoatrophy syndrome complications in patients with HIV1 infection

References

  1. Mallon PWG et al, Effect of pravastatin on body composition and markers of cardiovascular disease in HIV-infected men - A randomized. placebo-controlled study, AIDS 2006; 20:1003 PMID: 16603852 - Gharakhanian S et al, Statins in HIV-associated lipodystrophy and metabolic syndrome: Is there a missing link? AIDS 2006; 20:164 PMID: 16603860
  2. NEJM Knowledge+ Endocrinology