Lipodystrophy syndrome(s)

November 2001     View PDF     En español

What are cholesterol and triglyceride levels?

Two specific lab measures are discussed often in this discussion paper. The first one for cholesterol checks how well your body processes fat and measures the amount of certain fats in blood. The second measure for triglyceride checks how well your body processes proteins. Both measures are important indicators for lipodystrophy and are becoming more often standard care.

Lipodystrophy appears slightly different between people on a protease inhibitor and those not. People using only nucleoside analogues rarely develop changes in cholesterol or triglyceride levels, but they usually have a large weight loss before any change in body shape. In contrast, most people on protease inhibitors with lipodystrophy have increases in triglyceride and cholesterol levels and little or no change in overall weight. In both cases changes in body appearance occurred. They may well have unique causes in each situation—perhaps requiring different forms of prevention and intervention.

Results from the SALSA Study of 140 men and 30 women suggest that how long someone uses three-drug therapy may contribute to changes in body appearance. In this study only a few people who used three-drug therapy for less than a year developed lipodystrophy. About half of those on therapy for one to three years showed some evidence of changes in body shape.

However, there was no control group of people who had never taken any anti-HIV therapy. So it’s unclear if the increased rate of lipodystrophy is associated more with the longer use of anti-HIV therapy or the longer duration of HIV infection. As noted earlier, changes in body shape were observed in the time before potent therapies were available. They’re even seen in some people taking no therapy whatsoever.