Lipodystrophy in HIV Disease Video Transcript

Webcast Transcript

COHAN, MD: They found that people who are over age 40, people who have been on antiviral therapies for a longer period of time, people who have been HIV positive for more than seven years or have had an AIDS diagnosis for more than two years, people who have had a very low T-cell count at some point in time- these are non-drug risk factors for developing lipodystrophy.

ANNOUNCER: Other risk factors identified included: Caucasian ethnicity, family history of diabetes, low body mass, high viral load and a quick increase in T cells after starting medication.

Despite all the research, doctors still have not been able to define exactly what causes the condition.

GARY R. COHAN, MD: Lipodystrophy probably is not one single condition. It's probably a bunch of overlapping conditions and that's why it's been so difficult to define.

ANNOUNCER: Some patients with lipodystrophy can be helped by changing anti-retroviral regimens. Cholesterol and triglyceride levels can be lowered through exercise, changes in diet and with medication. Fat loss is proving harder to treat, except, perhaps, with plastic surgery.

Concerns over the cosmetic aspects of lipodystrophy, coupled with misunderstandings about its causes, are interfering with treatment decisions. GARY R. COHAN, MD: I do have patients who are afraid to start antiviral therapy because they are afraid that the medications are the causative agents - are going to cause lipodystrophy.

ANNOUNCER: Other patients are demanding breaks in their therapy - a course that's still experimental and controversial. But doctors say the most dangerous symptoms of lipodystrophy are very treatable and that patients must realize there's no reason to avoid HIV medications.

GARY R. COHAN, MD: There's so many different factors that come into play in the development of lipodystrophy that I think the take-home message for the patient is: "Don't be afraid of your medications because it's not just the medications."

And I think a person needs to weigh the risks and benefits of antiviral therapy against the potential risks of lipodystrophy. And I would argue that in almost every case, the benefits of antiviral therapy will win out.

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