Lipodystrophy is a disease characterized by an accumulation and / or loss of fatty tissue.

This pathology refers to changes in the body and develops in particular in patients infected with HIV (Acquired Immunodeficiency Virus). Lipodystrophy can be defined by an accumulation of adipose tissue (fat) or on the contrary, by a loss of this type of tissue.

These accumulations or loss of adipose tissue can affect a number of parts of the body.

The accumulations are mainly located:

– in the abdomen;

– behind the neck, between the shoulders;

– at chest level;

– on the face ;

– just below the upper surface of the skin, creating lipomas.

The loss of adipose tissue, for its part, is mainly localized;

– in the arms and legs;

– at the level of the buttocks;

– at the level of the face.

An individual affected by the disease may experience loss or accumulation of these fats, or both, at different levels of the body.

Much research has hypothesized a link between taking certain drugs (especially in the treatment of AIDS) and the development of lipodystrophy.

Fat loss is usually associated with taking drugs from the nucleotide reverse transcriptase inhibitor class, used in triple therapy against HIV infection.

Gains in fatty masses are, for their part, more caused by taking protease inhibitors, non-nucleotide reverse transcriptase inhibitors or even integrase inhibitors.

In addition, other origins of the disease have also been the subject of research, in particular concerning infections, damage to the immune system, etc.

A buildup of fatty tissue in the abdominal cavity can increase the risk of heart attacks or diabetes. In the chest, it can cause severe pain, or headaches, or breathing problems. (1)

Lipodystrophy affects several parts of the body which can vary depending on the accumulation of adipose tissue, or conversely on its decrease.

However, the loss of fatty mass can be focused, especially if it is related to panniculitis (inflammation of the upper part of the skin surface).

The associated symptoms can be defined through:

– a voracious appetite;

– an acceleration of growth in children or adolescents;

– acanthosis nigricans (skin abnormality);

– polycystic ovary syndrome;

– risk of diabetes and heart attacks.

Biologically, hyperinsulinemia (abnormally high level of insulin in the blood) is usually seen. This is frequently the subject of the development of insulin-resistant diabetes.

Proteinuria (presence of protein in the urine) has also been reported in the laboratory characteristics of the disease. (3)

The exact cause of the development of lipodystrophy is, to date, between unknown.

Research has looked at a potential link between HIV infection, particularly in the use of drugs to treat it, and the development of the disease.

New drugs in the treatment of AIDS make it possible to limit the development of lipodystrophy than older drugs, more generally used. (1)

Risk factors relating to the development of lipodystrophy come into play, such as:

– age: the older the individual, the greater the risk of developing the pathology;

– skin color: white populations have a higher risk of developing the disease;

– sex: men are more at risk of losing fatty tissue in the legs and arms. Women, on the other hand, are more likely to have fatty tissue build-up in the chest and abdomen;

– the level of severity of the HIV infection: the more severe the infection, the greater the risk of developing lipodystrophy.

Today, there is no cure for the disease. Much research is focused on determining the exact causes of lipodystrophy.

However, it has also been shown that changes in certain drugs in the treatment of HIV infection in patients with AIDS may help in the positive course of the disease. These therapeutic changes must be effective only on the advice of the doctor.

Liposuction (the removal of fatty tissue through surgery) is sometimes used to reduce fat build-up to certain levels. However, this means is not used in the context of fatty accumulation in the abdomen, which can cause damage to neighboring organs.

The injection of fatty substances can be effective in the context of fat loss in the cheeks, eyes and mouth.

Medicines can help reduce the effects of lipodystrophy. This is particularly the case with tesamoreline, which reduces the accumulation of abdominal fat.

Finally, an adapted diet, a healthy lifestyle and daily physical exercises reduce the accumulation of fatty mass in different places. (1)