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AIDS Research and Therapy
Published in: AIDS Research and Therapy 1/2007

Open Access 01-12-2007 | Review

HIV-associated adipose redistribution syndrome (HARS): definition, epidemiology and clinical impact

Authors: Kenneth Lichtenstein, Ashok Balasubramanyam, Rajagopal Sekhar, Eric Freedland

Published in: AIDS Research and Therapy | Issue 1/2007

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Abstract

A segment of the HIV infected population develops abnormal and excessive accumulation of adipose tissue in the trunk, including accumulation of visceral (deep abdominal) adipose tissue. This condition, known as HIV-related adipose redistribution syndrome (HARS), may also be accompanied by fat accumulation in the upper back/neck (dorsocervical region) and/or depletion of subcutaneous adipose tissue from the abdomen, face, limbs, or buttocks. HARS is estimated to occur in up to 32% of patients and is associated with health risks similar to those of metabolic syndrome. Techniques to detect and measure HARS include physician and patient assessments and radiologic or anthropometric methods.
Literature
1.
Garcia-Viejo MA, Ruiz M, Martinez E: Strategies for treating HIV-related lipodystrophy. Expert Opin Investig Drugs. 2001, 10: 1443-1456. 10.1517/13543784.10.8.1443PubMedCrossRef
2.
Powderly WG: Long-term exposure to lifelong therapies. J Acquir Immune Defic Syndr. 2002, 29 (Suppl 1): S28-40.PubMedCrossRef
3.
Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, Cooper DA: A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998, 12: F51-58. 10.1097/00002030-199807000-00003PubMedCrossRef
4.
Engelson ES, Kotler DP, Tan Y, Agin D, Wang J, Pierson RN, Heymsfield SB: Fat distribution in HIV-infected patients reporting truncal enlargement quantified by whole-body magnetic resonance imaging. Am J Clin Nutr. 1999, 69: 1162-1169.PubMed
5.
Herry I, Bernand L, de Truchis P, Perronn C: Hypertrophy of the breasts in a patient treated with indinavir. Clin Infect Dis. 1997, 25: 937-938.PubMedCrossRef
6.
Lo JC, Mulligan K, Tai VW, Algren H, Schambelan M: "Buffalo hump" in men with HIV-1 infection. Lancet. 1998, 351: 867-870. 10.1016/S0140-6736(97)11443-XPubMedCrossRef
7.
Massip P, Marchou B, Bonnet E, Cuzin L, Montastruc JL: Lipodystrophia with protease inhibitors in HIV patients. Therapie. 1997, 52: 615-PubMed
8.
Miller KD, Jones E, Yanovski JA, Shankar R, Feuerstein I, Falloon J: Visceral abdominal-fat accumulation associated with use of indinavir. Lancet. 1998, 351: 871-875. 10.1016/S0140-6736(97)11518-5PubMedCrossRef
9.
Bacchetti P, Gripshover B, Grunfeld C, Heymsfield S, McCreath H, Osmond D, Saag M, Scherzer R, Shlipak M, Tien P: Fat distribution in men with HIV infection. J Acquir Immune Defic Syndr. 2005, 40: 121-131. 10.1097/01.qai.0000182230.47819.aaPubMedCrossRef
10.
Safrin S, Grunfeld C: Fat distribution and metabolic changes in patients with HIV infection. AIDS. 1999, 13: 2493-2505. 10.1097/00002030-199912240-00002PubMedCrossRef
11.
Sattler F: Body habitus changes related to lipodystrophy. Clin Infect Dis. 2003, 36: S84-90. 10.1086/367563PubMedCrossRef
12.
Tien PC, Grunfeld C: What is HIV-associated lipodystrophy? Defining fat distribution changes in HIV infection. Curr Opin Infect Dis. 2004, 17: 27-32. 10.1097/00001432-200402000-00005PubMedCrossRef
13.
Freedland ES: Role of a critical visceral adipose tissue threshold (CVATT) in metabolic syndrome: implications for controlling dietary carbohydrates: a review. Nutr Metab (Lond). 2004, 1: 12- 10.1186/1743-7075-1-12CrossRef
14.
Vigano A, Mora S, Manzoni P, Schneider L, Beretta S, Molinaro M, di Natale B, Brambilla P: Effects of recombinant growth hormone on visceral fat accumulation: pilot study in human immunodeficiency virus-infected adolescents. J Clin Endocrinol Metab. 2005, 90: 4075-4080. 10.1210/jc.2004-2431PubMedCrossRef
15.
Yin MT, Glesby MJ: Recombinant human growth hormone therapy in HIV-associated wasting and visceral adiposity. Expert Rev Anti Infect Ther. 2005, 3: 727-738. 10.1586/14787210.3.5.727PubMedCrossRef
16.
Roth VR, Kravcik S, Angel JB: Development of cervical fat pads following therapy with human immunodeficiency virus type 1 protease inhibitors. Clin Infect Dis. 1998, 27: 65-67. 10.1086/514639PubMedCrossRef
17.
Torres RA, Unger KW, Cadman JA, Kassous JY: Recombinant human growth hormone improves truncal adiposity and 'buffalo humps' in HIV-positive patients on HAART. AIDS. 1999, 13: 2479-2481. 10.1097/00002030-199912030-00023PubMedCrossRef
18.
Zolopa A, Benson C, Bacchetti P, Tien PC, Grunfeld C: Buffalo hump in men with HIV Infection: Larger, but not more common. 10th Conference on Retroviruses and Opportunistic Infections: Incidence, Prevalence, and Impact of Body Composition Abnormalities; Boston, MA. 2003,
19.
Lichtenstein KA, Delaney KM, Armon C, Ward DJ, Moorman AC, Wood KC, Holmberg SD: Incidence of and risk factors for lipoatrophy (abnormal fat loss) in ambulatory HIV-1-infected patients. J Acquir Immune Defic Syndr. 2003, 32: 48-56.PubMedCrossRef
20.
Martin A, Mallon PW: Therapeutic approaches to combating lipoatrophy: do they work?. J Antimicrob Chemother. 2005, 55: 612-615. 10.1093/jac/dki062PubMedCrossRef
21.
Parruti G, Toro GM: Persistence of lipoatrophy after a four-year long interruption of antiretroviral therapy for HIV1 infection: case report. BMC Infect Dis. 2005, 5: 80- 10.1186/1471-2334-5-80PubMedCentralPubMedCrossRef
22.
Fliers E, Sauerwein HP, Romijn JA, Reiss P, van der Valk M, Kalsbeek A, Kreier F, Buijs RM: HIV-associated adipose redistribution syndrome as a selective autonomic neuropathy. Lancet. 2003, 362: 1758-1760. 10.1016/S0140-6736(03)14858-1PubMedCrossRef
23.
Grunfeld C, Thompson M, Brown SJ, Richmond G, Lee D, Muurahainen N, Kotler DP: Recombinant Human Growth Hormone to Treat HIV-Associated Adipose Redistribution Syndrome: 12-Week Induction and 24-Week Maintenance Therapy. J Acquir Immune Defic Syndr. 2007, 45: 286-297.PubMed
24.
Kotler DP, Muurahainen N, Grunfeld C, Wanke C, Thompson M, Saag M, Bock D, Simons G, Gertner JM: Effects of growth hormone on abnormal visceral adipose tissue accumulation and dyslipidemia in HIV-infected patients. J Acquir Immune Defic Syndr. 2004, 35: 239-252. 10.1097/00126334-200403010-00004PubMedCrossRef
25.
Kotler DP, Muurahainen N, Grunfeld C, Wanke C, Thompson M, Saag M, Bock D, Simons G, Gertner JM: Effects of growth hormone on visceral adipose tissue and dyslipidemia in HIV, an erratum. J Acquir Immune Defic Syndr. 2006, 43: 378-380. 10.1097/01.qai.0000243108.26136.66PubMedCrossRef
26.
27.
van Gurp PJ, Tack CJ, van der Valk M, Reiss P, Lenders JW, Sweep FC, Sauerwein HP: Sympathetic nervous system function in HIV-associated adipose redistribution syndrome. AIDS. 2006, 20: 773-775. 10.1097/01.aids.0000216379.91936.84PubMedCrossRef
28.
Dolan SE, Hadigan C, Killilea KM, Sullivan MP, Hemphill L, Lees RS, Schoenfeld D, Grinspoon S: Increased cardiovascular disease risk indices in HIV-infected women. J Acquir Immune Defic Syndr. 2005, 39: 44-54. 10.1097/01.qai.0000159323.59250.83PubMedCrossRef
29.
Hadigan C, Meigs JB, Corcoran C, Rietschel P, Piecuch S, Basgoz N, Davis B, Sax P, Stanley T, Wilson PW: Metabolic abnormalities and cardiovascular disease risk factors in adults with human immunodeficiency virus infection and lipodystrophy. Clin Infect Dis. 2001, 32: 130-139. 10.1086/317541PubMedCrossRef
30.
Turner R, Testa MA, Su M, Richmond G, Muurahainen N, Kotler DP, Thompson M: The impact of HIV-associated adipose redistribution syndrome (HARS) on health-related quality of life. Antiviral Therapy. 2006, 11: L25
31.
Gripshover B, Tien PC, Saag M, Osmond D, Bacchetti P, Grunfeld C: Lipoatrophy is the Dominant Feature of the Lipodystrophy Syndrome in HIV-infected Men. Conf Retrovir Oppor Infect. 2003,
32.
Carr A: HIV lipodystrophy: risk factors, pathogenesis, diagnosis and management. AIDS. 2003, 17 (Suppl 1): S141-148.PubMedCrossRef
33.
Engelson ES: HIV lipodystrophy diagnosis and management. Body composition and metabolic alterations: diagnosis and management. AIDS Read. 2003, 13: S10-14.PubMed
34.
Mondy K, Tong S, Kessels L, Powderly W, Overton E: Metabolic Syndrome in HIV within a Representative US patient Population. 13th Conference on Retroviruses and Opportunistic Infections: Metabolic Syndrome and Other Abnormalities of Fat, Lipid, Glucose and Bone Metabolism. Denver, CO. 2006,
35.
Kotler D, Engelson E, Heymsfield S, Chang P, Muurahainen N, Gertner J: Anthropometric Criteria define visceral fat excess in patients with HIV-associated adipose redistribution syndrome (HARS), a subset of HIV lipodystrophy (abstract). 9th Conference on Retroviruses and Opportunistic Infections: Incidence, Prevalence, and Pathogenic Correlates of Insulin Resistance and Lipodystrophy Syndrome, Seattle, WA. 2002,
36.
Kotler DP, Muurahainen N, Chang P, Engelson ES, Wang J, Heymsfield SB, Gertner JM: Anthropometric equations select HIV+ men and women with distinctly abnormal fat accumulation and distribution. Int Conf AIDS; 2002 Jul 7-12;14:(abstract no. WePeB5997). 2002,
37.
Wanke C: Editorial comment: a case definition for HIV lipodystrophy – a work in progress. AIDS Read. 2003, 13: 492-493.PubMed
38.
Benavides S, Nahata MC: Pharmacologic therapy for HIV-associated lipodystrophy. Ann Pharmacother. 2004, 38: 448-457. 10.1345/aph.1D081PubMedCrossRef
39.
Belloso WH, Quiros RE, Ivalo SA, Perman MI, Galich AM, Stern LD, Barcan LA: Agreement analysis of variables involved in lipodystrophy syndrome definition in HIV-infected patients. J Acquir Immune Defic Syndr. 2003, 32: 104-111.PubMedCrossRef
40.
Carr A, Emery S, Law M, Puls R, Lundgren JD, Powderly WG: An objective case definition of lipodystrophy in HIV-infected adults: a case-control study. Lancet. 2003, 361: 726-735. 10.1016/S0140-6736(03)12656-6PubMedCrossRef
41.
Carr A, Law M, HIV Lipodystrophy Case Definition Study Group: An objective lipodystrophy severity grading scale derived from the lipodystrophy case definition score. J Acquir Immune Defic Syndr. 2003, 33: 571-576. 10.1097/00126334-200308150-00004PubMedCrossRef
42.
Thiebaut R, Daucourt V, Mercie P, Ekouevi DK, Malvy D, Morlat P, Dupon M, Neau D, Farbos S, Marimoutou C, Dabis F: Lipodystrophy, metabolic disorders, and human immunodeficiency virus infection: Aquitaine Cohort, France, 1999. Groupe d'Epidemiologie Clinique du Syndrome d'Immunodeficience Acquise en Aquitaine. Clin Infect Dis. 2000, 31: 1482-1487. 10.1086/317477PubMedCrossRef
43.
Miller JE, Emery S, French M, Baker D, Cooper DA: The Australian prevalence survey of lipodystrophy. 7th Conference on Retroviruses and Opportunistic Infections. San Francisco, CA; 2000. 2000,
44.
Ward DJ, Delaney KM, Moorman AC, Lichtenstein K, Palella F, Young B, Wood KC, Holmberg SD: Description of lipodystrophy in the HIV outpatient study (HOPS). Antiviral Therapy. 1999, 4(Suppl 2):
45.
Saint-Marc T, Partisani M, Poizot-Martin I, Rouviere O, Bruno F, Avellaneda R, Lang JM, Gastaut JA, Touraine JL: Fat distribution evaluated by computed tomography and metabolic abnormalities in patients undergoing antiretroviral therapy: preliminary results of the LIPOCO study. AIDS. 2000, 14: 37-49. 10.1097/00002030-200001070-00005PubMedCrossRef
46.
Bergersen BM, Sandvik L, Bruun JN: Body composition changes in 308 Norwegian HIV-positive patients. Scand J Infect Dis. 2004, 36: 186-191. 10.1080/00365540410019273PubMedCrossRef
47.
Bernasconi E, Boubaker K, Junghans C, Flepp M, Furrer HJ, Haensel A, Hirschel B, Boggian K, Chave JP, Opravil M: Abnormalities of body fat distribution in HIV-infected persons treated with antiretroviral drugs: The Swiss HIV Cohort Study. J Acquir Immune Defic Syndr. 2002, 31: 50-55.PubMedCrossRef
48.
Miller J, Brown D, Amin J, Kent-Hughes J, Law M, Kaldor J, Cooper DA, Carr A: A randomized, double-blind study of gemfibrozil for the treatment of protease inhibitor-associated hypertriglyceridaemia. AIDS. 2002, 16: 2195-2200. 10.1097/00002030-200211080-00012PubMedCrossRef
49.
Miller J, Carr A, Emery S, Law M, Mallal S, Baker D, Smith D, Kaldor J, Cooper DA: HIV lipodystrophy: prevalence, severity and correlates of risk in Australia. HIV Med. 2003, 4: 293-301. 10.1046/j.1468-1293.2003.00159.xPubMedCrossRef
50.
Lichtenstein K, Wanke C, Henry K, Thompson M, Muurahainen N, Kotler DP: Estimated Prevalence of HIV-associated adipose redistribution syndrome (HARS) – abnormal abdominal fat accumulation – in HIV-infected patients. Antiviral Therapy. 2004, 9: L33-
51.
Paparizos VA, Kyriakis KP, Polydorou-Pfandl D, Hadjivassiliou M, Stavrianeas NG: Epidemiologic characteristics of Koebner's phenomenon in AIDS-related Kaposi's sarcoma. J Acquir Immune Defic Syndr. 2000, 25: 283-284. 10.1097/00042560-200011010-00013PubMedCrossRef
52.
Rozenbaum W, Gharakhanian S, Salhi Y, Adda N, Nguyen T, Vigouroux C, Capeau J: Antivir Ther. 1999, 4 (Suppl 2): L34
53.
Saves M, Raffi F, Capeau J, Rozenbaum W, Ragnaud JM, Perronne C, Basdevant A, Leport C, Chene G: Factors related to lipodystrophy and metabolic alterations in patients with human immunodeficiency virus infection receiving highly active antiretroviral therapy. Clin Infect Dis. 2002, 34: 1396-1405. 10.1086/339866PubMedCrossRef
54.
Kotler D: Update from the 7th international workshop on adverse drug reactions and lipodystrophy in HIV. The PRN Notebook. 2006, 11: 16-21.
55.
Mulligan K, Parker R, Komarow L, Tebas P, Grinspoon S, Robbins G, Dube M: Mixed patterns of changes in central and peripheral fat following initiation of ART. 12th Conference on Retroviruses and Opportunistic Infections, Boston, MA; 2005. 2005,
56.
Kuk JL, Katzmarzyk PT, Nichaman MZ, Church TS, Blair SN, Ross R: Visceral Fat Is an Independent Predictor of All-cause Mortality in Men. Obesity (Silver Spring) Research. 2006, 14: 336-341.CrossRef
57.
Grunfeld C, Tien P: Difficulties in understanding the metabolic complications of acquired immune deficiency syndrome. Clin Infect Dis. 2003, 37 (Suppl 2): S43-46. 10.1086/375886PubMedCrossRef
58.
NCEP: Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. 10.1001/jama.285.19.2486CrossRef
59.
Wohl DA: Body shape, lipid, and cardiovascular complications of HIV therapy. Curr HIV/AIDS Rep. 2005, 2: 74-82. 10.1007/s11904-005-0022-6PubMedCrossRef
60.
Lebovitz HE, Banerji MA: Point: visceral adiposity is causally related to insulin resistance. Diabetes Care. 2005, 28: 2322-2325. 10.2337/diacare.28.9.2322PubMedCrossRef
61.
Goodpaster BH, Kelley DE, Wing RR, Meier A, Thaete FL: Effects of weight loss on regional fat distribution and insulin sensitivity in obesity. Diabetes. 1999, 48: 839-847. 10.2337/diabetes.48.4.839PubMedCrossRef
62.
Calza L, R M, F C: Insulin resistance and diabetes mellitus in HIV infected patients receiving antiretroviral therapy. Metabolic Syndrome and Related Disorders. 2004, 2: 241-250. 10.1089/met.2004.2.241.PubMedCrossRef
63.
Balasubramanyam A, Sekhar RV, Jahoor F, Jones PH, Pownall HJ: Pathophysiology of dyslipidemia and increased cardiovascular risk in HIV lipodystrophy: a model of 'systemic steatosis'. Curr Opin Lipidol. 2004, 15: 59-67. 10.1097/00041433-200402000-00011PubMedCrossRef
64.
Hadigan C, Kamin D, Liebau J, Mazza S, Barrow S, Torriani M, Rubin R, Weise S, Fischman A, Grinspoon S: Depot-specific regulation of glucose uptake and insulin sensitivity in HIV-lipodystrophy. Am J Physiol Endocrinol Metab. 2006, 290: E289-298. 10.1152/ajpendo.00273.2005PubMedCentralPubMedCrossRef
65.
Mallon PW, Wand H, Law M, Miller J, Cooper DA, Carr A, HIV Lipodystrophy Case Definition Study; Australian Lipodystrophy Prevalence Survey Investigators: Buffalo hump seen in HIV-associated lipodystrophy is associated with hyperinsulinemia but not dyslipidemia. J Acquir Immune Defic Syndr. 2005, 38: 156-162. 10.1097/01.qai.0000147527.64863.1aPubMedCrossRef
66.
Shikuma CM, Day LJ, Gerschenson M: Insulin resistance in the HIV-infected population: the potential role of mitochondrial dysfunction. Curr Drug Targets Infect Disord. 2005, 5: 255-262. 10.2174/1568005054880163PubMedCrossRef
67.
Triant VA, Lee H, Hadigan C, Grinspoon SK: Increased Acute Myocardial Infarction Rates and Cardiovascular Risk Factors Among Patients with HIV Disease. J Clin Endocrinol Metab. 2007, 92: 2506-2512. 10.1210/jc.2006-2190PubMedCentralPubMedCrossRef
68.
Tanwani LK, Mokshagundam SL: Lipodystrophy, insulin resistance, diabetes mellitus, dyslipidemia, and cardiovascular disease in human immunodeficiency virus infection. South Med J. 2003, 96: 180-188. quiz 189., 10.1097/01.SMJ.0000051731.69719.2EPubMedCrossRef
69.
Henry K, Melroe H, Huebsch J, Hermundson J, Levine C, Swensen L, Daley J: Severe premature coronary artery disease with protease inhibitors. Lancet. 1998, 351: 1328 10.1016/S0140-6736(05)79053-XPubMedCrossRef
70.
Friis-Moller N, Reiss P, Sabin CA, Weber R, Monforte A, El-Sadr W, Thiebaut R, De Wit S, Kirk O, Fontas E: Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med. 2007, 356: 1723-1735. 10.1056/NEJMoa062744PubMedCrossRef
71.
Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L: Obesity and the risk of myocardial infarction in 27, 000 participants from 52 countries: a case-control study. Lancet. 2005, 366: 1640-1649. 10.1016/S0140-6736(05)67663-5PubMedCrossRef
72.
Meininger G, Hadigan C, Rietschel P, Grinspoon S: Body-composition measurements as predictors of glucose and insulin abnormalities in HIV-positive men. Am J Clin Nutr. 2002, 76: 460-465.PubMed
73.
Hadigan C, Meigs JB, Wilson PW, D'Agostino RB, Davis B, Basgoz N, Sax PE, Grinspoon S: Prediction of coronary heart disease risk in HIV-infected patients with fat redistribution. Clin Infect Dis. 2003, 36: 909-916. 10.1086/368185PubMedCrossRef
74.
Williams P, Wu J, Cohn S, Koletar S, McCutchan J, Murphy R, Currier J: Risk of Cardiovascular Disease in HIV-infected adults with immune reconstitution. 12th Conference on Retroviruses and Opportunistic Infections. Boston, MA; 2005. 2005, 12:
75.
Samaras K, Wand H, Law M, Emery S, Cooper D, Carr A: Prevalence of Metabolic Syndrome in HIV-Infected Patients Receiving Highly Active Antiretroviral Therapy Using International Diabetes Foundation and Adult Treatment Panel III Criteria: Associations with insulin resistance, disturbed body fat compartmentalization, elevated C-reactive peptide, and hypoadiponectinemia. Diabetes Care. 2007, 30: 113-119. 10.2337/dc06-1075PubMedCrossRef
76.
Samaras K, Wand H, Law M: Metabolic syndrome in HIV-infected patients using IDF and ATP-3 criteria, prevalence, discordance, and clinical utility. 8th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. San Francisco, CA; 2006. 2006,
77.
Despres JP, Lemieux I: Abdominal obesity and metabolic syndrome. Nature. 2006, 444: 881-887. 10.1038/nature05488PubMedCrossRef
78.
Ristig M, Drechsler H, Powderly WG: Hepatic steatosis and HIV infection. AIDS Patient Care STDS. 2005, 19: 356-365. 10.1089/apc.2005.19.356PubMedCrossRef
79.
Kelley DE, McKolanis TM, Hegazi RA, Kuller LH, Kalhan SC: Fatty liver in type 2 diabetes mellitus: relation to regional adiposity, fatty acids, and insulin resistance. Am J Physiol Endocrinol Metab. 2003, 285: E906-916.PubMedCrossRef
80.
Nguyen-Duy TB, Nichaman MZ, Church TS, Blair SN, Ross R: Visceral fat and liver fat are independent predictors of metabolic risk factors in men. Am J Physiol Endocrinol Metab. 2003, 284: E1065-1071.PubMedCrossRef
81.
Reeds DN, Yarasheski KE, Fontana L, Cade WT, Laciny E, DeMoss A, Patterson BW, Powderly WG, Klein S: Alterations in liver, muscle, and adipose tissue insulin sensitivity in men with HIV infection and dyslipidemia. Am J Physiol Endocrinol Metab. 2006, 290: E47-E53. 10.1152/ajpendo.00236.2005PubMedCrossRef
82.
Meininger G, Hadigan C, Laposata M, Brown J, Rabe J, Louca J, Aliabadi N, Grinspoon S: Elevated concentrations of free fatty acids are associated with increased insulin response to standard glucose challenge in human immunodeficiency virus-infected subjects with fat redistribution. Metabolism. 2002, 51: 260-266. 10.1053/meta.2002.29999PubMedCrossRef
83.
Feve B: Adipogenesis: cellular and molecular aspects. Best Pract Res Clin Endocrinol Metab. 2005, 19: 483-499. 10.1016/j.beem.2005.07.007PubMedCrossRef
84.
Sutinen J, Hakkinen AM, Westerbacka J, Seppala-Lindroos A, Vehkavaara S, Halavaara J, Jarvinen A, Ristola M, Yki-Jarvinen H: Increased fat accumulation in the liver in HIV-infected patients with antiretroviral therapy-associated lipodystrophy. AIDS. 2002, 16: 2183-2193. 10.1097/00002030-200211080-00011PubMedCrossRef
85.
Luzi L, Perseghin G, Tambussi G, Meneghini E, Scifo P, Pagliato E, Del Maschio A, Testolin G, Lazzarin A: Intramyocellular lipid accumulation and reduced whole body lipid oxidation in HIV lipodystrophy. Am J Physiol Endocrinol Metab. 2003, 284: E274-280.PubMedCrossRef
86.
Martinez E, Garcia-Viejo MA, Blanch L, Gatell JM: Lipodystrophy syndrome in patients with HIV infection: quality of life issues. Drug Saf. 2001, 24: 157-166. 10.2165/00002018-200124030-00001PubMedCrossRef
87.
Persson A: Facing HIV: body shape change and the (in)visibility of illness. Med Anthropol. 2005, 24: 237-264. 10.1080/01459740500182683PubMedCrossRef
88.
Duran S, Saves M, Spire B, Cailleton V, Sobel A, Carrieri P, Salmon D, Moatti JP, Leport C: Failure to maintain long-term adherence to highly active antiretroviral therapy: the role of lipodystrophy. AIDS. 2001, 15: 2441-2444. 10.1097/00002030-200112070-00012PubMedCrossRef
89.
Hawkins T: Appearance-related side effects of HIV-1 treatment. AIDS Patient Care STDS. 2006, 20: 6-18. 10.1089/apc.2006.20.6PubMedCrossRef
90.
Burgoyne R, Collins E, Wagner C, Abbey S, Halman M, Nur M, Walmsley S: The relationship between lipodystrophy-associated body changes and measures of quality of life and mental health for HIV-positive adults. Qual Life Res. 2005, 14: 981-990. 10.1007/s11136-004-2580-2PubMedCrossRef
91.
Engelson ES: Interventions for visceral adiposity associated with human immunodeficiency virus: application of a method for assessing efficacy. Clin Infect Dis. 2003, 37 (Suppl 2): S96-100. 10.1086/375880PubMedCrossRef
92.
Grinspoon S, Gelato M: Editorial: The rational use of growth hormone in HIV-infected patients. J Clin Endocrinol Metab. 2001, 86: 3478-3479. 10.1210/jc.86.8.3478PubMedCrossRef
93.
Reynolds NR, Neidig JL, Wu AW, Gifford AL, Holmes WC: Balancing disfigurement and fear of disease progression: Patient perceptions of HIV body fat redistribution. AIDS Care. 2006, 18: 663-673. 10.1080/09540120500287051PubMedCrossRef
94.
Gold DR, Annino DJ: HIV-associated cervicodorsal lipodystrophy: etiology and management. Laryngoscope. 2005, 115: 791-795. 10.1097/01.MLG.0000161838.22766.88PubMedCrossRef
95.
Guaraldi G, Orlando G, Squillace N, Roverato A, De Fazio D, Vandelli M, Nardini G, Beghetto B, De Paola M, Esposito R, Palella F: Prevalence of and Risk Factors for Pubic Lipoma Development in HIV-Infected Persons. J Acquir Immune Defic Syndr. 2007, 45: 72-76. 10.1097/QAI.0b013e31804a85b0PubMedCrossRef
96.
Chen D, Misra A, Garg A: Clinical review 153: Lipodystrophy in human immunodeficiency virus-infected patients. J Clin Endocrinol Metab. 2002, 87: 4845-4856. 10.1210/jc.2002-020794PubMedCrossRef
97.
98.
Garg A: Acquired and inherited lipodystrophies. N Engl J Med. 2004, 350: 1220-1234. 10.1056/NEJMra025261PubMedCrossRef
99.
Garg A, Peshock RM, Fleckenstein JL: Adipose tissue distribution pattern in patients with familial partial lipodystrophy (Dunnigan variety). J Clin Endocrinol Metab. 1999, 84: 170-174. 10.1210/jc.84.1.170PubMed
100.
Kosmiski L, Kuritzkes D, Hamilton J, Sharp T, Lichtenstien K, Hill J, Eckel R: Fat distribution is altered in HIV-infected men without clinical evidence of the HIV lipodystrophy syndrome. HIV Med. 2003, 4: 235-240. 10.1046/j.1468-1293.2003.00151.xPubMedCrossRef
101.
Brown T, Wang Z, Chu H, Palella F, Kingsley L, Witt MD, Dobs AS: Longitudinal Anthropometric Changes in HIV-Infected and HIV-Uninfected Men. J Acquir Immune Defic Syndr. 2006, 43: 356-362. 10.1097/01.qai.0000243052.73321.8ePubMedCrossRef
102.
Palella FJ, Chmiel JS, Riddler SA, Calhoun B, Dobs A, Visscher B, Kingsley L: A novel pattern of lipoaccumulation in HIV-infected men. JAMA. 2006, 296: 766-768. 10.1001/jama.296.7.766PubMedCrossRef
103.
Schwenk A: Methods of assessing body shape and composition in HIV-associated lipodystrophy. Curr Opin Infect Dis. 2002, 15: 9-16.PubMedCrossRef
104.
Schwenk A, Breuer P, Kremer G, Ward L: Clinical assessment of HIV-associated lipodystrophy syndrome: bioelectrical impedance analysis, anthropometry and clinical scores. Clin Nutr. 2001, 20: 243-249. 10.1054/clnu.2001.0395PubMedCrossRef
105.
Falutz J, Allas S, Kotler D, Thompson M, Koutkia P, Albu J, Trottier B, Routy JP, Cote P, Abribat T, Grinspoon S: A placebo-controlled, dose-ranging study of a growth hormone releasing factor in HIV-infected patients with abdominal fat accumulation. AIDS. 2005, 19: 1279-1287. 10.1097/01.aids.0000180099.35146.30PubMedCrossRef
106.
Molarius A, Seidell JC: Selection of anthropometric indicators for classification of abdominal fatness – a critical review. Int J Obes Relat Metab Disord. 1998, 22: 719-727. 10.1038/sj.ijo.0800660PubMedCrossRef
107.
Chang P, Kotler DP, Engelson ES, Gertner JG, Kenley S, Muurahainen N: Anthropometric equations distinguish between HIV+ subjects affected and unaffected with HIV-associated adipose redistribution syndrome (HARS). 40th ICAAC. Toronto, Canada. 2000,
108.
Fichtenbaum CJ, Hadigan CM, Kotler DP, Pierone G, Sax PE, Steinhart CR, Tebas P: Treating morphologic and metabolic complications in HIV-infected patients on antiretroviral therapy. A consensus statement of an advisory committee of the International Association of Physicians in AIDS Care. IAPAC Mon. 2005, 11: 38-46.PubMed
109.
Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G: Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br Med J (Clin Res Ed). 1984, 288: 1401-1404.CrossRef
110.
Schambelan M, Benson CA, Carr A, Currier JS, Dube MP, Gerber JG, Grinspoon SK, Grunfeld C, Kotler DP, Mulligan K: Management of metabolic complications associated with antiretroviral therapy for HIV-1 infection: recommendations of an International AIDS Society-USA panel. J Acquir Immune Defic Syndr. 2002, 31: 257-275.PubMedCrossRef
111.
Cavalcanti RB, Cheung AM, Raboud J, Walmsley S: Reproducibility of DXA estimations of body fat in HIV lipodystrophy: implications for clinical research. J Clin Densitom. 2005, 8: 293-297. 10.1385/JCD:8:3:293PubMedCrossRef
112.
Wang J: Standardization of waist circumference reference data. Am J Clin Nutr. 2006, 83: 3-4.PubMed
Metadata
Title
HIV-associated adipose redistribution syndrome (HARS): definition, epidemiology and clinical impact
Authors
Kenneth Lichtenstein
Ashok Balasubramanyam
Rajagopal Sekhar
Eric Freedland
Publication date
01-12-2007
Publisher
BioMed Central
Published in
AIDS Research and Therapy / Issue 1/2007
Electronic ISSN: 1742-6405
DOI
https://doi.org/10.1186/1742-6405-4-16

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