Management of HIV-associated lipodystrophy: Medical and surgical options for lipoatrophy and lipohypertrophy

Over 25 years after the first published cases of the acquired immunodeficiency syndrome in 1981, human immunodeficiency virus (HIV) has infected an estimated 65 million people and resulted in at least 25 million deaths [1]. During the latter part of the 1990s, potent HIV therapies became available and produced a dramatic improvement in the prognosis of this fatal viral illness. Suppression of viral replication by highly active antiretroviral therapies (HAART) and subsequent increases in CD4+ cell count have yielded increases in disease-free survival. The benefits of HAART, however, have been tempered by the development of metabolic complications and morphologic changes in patients receiving these therapies, which may occur in 10-60% of this population [2].