Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

Long-term effect of highly active antiretroviral therapy on cervical lesions in HIV-positive women

AIDS ◽  
2003 ◽  
Vol 17 (14) ◽  
pp. 2136-2138 ◽  
Author(s):  
Caterina Uberti-Foppa ◽  
Davide Ferrari ◽  
Sara Lodini ◽  
Salvatore Reina ◽  
Franco Ameglio ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Term Effect ◽  
Hiv Positive ◽  
Cervical Lesions ◽  
Highly Active ◽  
Hiv Positive Women ◽  
Long Term Effect

scholarly journals Long-Term Effects of Highly Active Antiretroviral Therapy in Pretreated, Vertically HIV Type 1-Infected Children: 6 Years of Follow-Up

2006 ◽  
Vol 42 (6) ◽  
pp. 862-869 ◽  
Author(s):  
S. Resino ◽  
R. Resino ◽  
D. Micheloud ◽  
D. Gurbindo-Gutierrez ◽  
J. A. Leon ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Long Term Effects ◽  
Highly Active ◽  
Hiv Type 1

Incidence and risk factors for invasive pneumococcal disease in HIV-positive individuals in the era of highly active antiretroviral therapy

2019 ◽  
Vol 30 (5) ◽  
pp. 472-478 ◽  
Author(s):  
C Sadlier ◽  
Sarah O’Connell ◽  
M Kelleher ◽  
C Bergin
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Pneumococcal Vaccine ◽  
Linear Trend ◽  
Case Fatality ◽  
Hiv Care ◽  
Hiv Positive ◽  
Highly Active

Invasive pneumococcal diseases (IPDs) remain a significant cause of morbidity and mortality in human immunodeficiency virus (HIV)-positive individuals despite the widespread use of highly active antiretroviral therapy (HAART) and availability of pneumococcal vaccines. The aim of this study was to measure temporal trends in incidence and risk factors for IPD (defined as culture of Streptococcus pneumoniae from blood, cerebrospinal fluid or both) in a cohort of HIV-positive patients attending an ambulatory HIV care centre in Dublin, Ireland over a 10-year period 2006–2015. Incidence of IPD was determined as events per 100,000 person-years’ follow-up. Poisson regression was used to assess linear trend in incidence over time. A nested case–control study (four controls per case) was undertaken to assess risk factors for IPD. Forty-seven episodes of IPD were identified in 42 HIV-positive individuals (median [IQR] age 38 years [33–43], 69% male, 86% injecting drug users (IDUs), median CD4 T-cell count 213 cells/mm3) over 16,008 person-years’ follow-up (overall incidence rate 293/100,000 person-years). Three patients had two episodes and one patient had three episodes of IPD during the study period. The overall case fatality rate was 15% (95% confidence interval [CI] 4–24%). The incidence of IPD per 100,000 person-years decreased from 728 (95% CI, 455–1002), to 242 (95% CI, 120–365) to 82 (95% CI, 40–154) in calendar periods 2006–2008, 2009–2012 and 2013–2015, respectively (p < 0.01 for linear trend). Older age (p = 0.02), male gender (p = 0.05), detectable HIV viral load (p < 0.01) and non-receipt of pneumococcal vaccine (p = 0.03) were associated with IPD while IDU as risk of acquisition of HIV was of borderline significance (p = 0.06). HIV-positive individuals remain at greater risk of IPD compared to the general population. Pneumococcal vaccine should be seen as a priority to ensure optimal protection for HIV-positive patients.

scholarly journals Nutritional assessment and lipid profile in HIV-infected children and adolescents treated with highly active antiretroviral therapy

2011 ◽  
Vol 44 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Marina Hjertquist Tremeschin ◽  
Daniela Saes Sartorelli ◽  
Maria Célia Cervi ◽  
Bento Vidal de Moura Negrini ◽  
Roberta Garcia Salomão ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Protease Inhibitor ◽  
Children And Adolescents ◽  
Highly Active Antiretroviral Therapy ◽  
Serum Levels ◽  
Hiv Positive ◽  
Control Group ◽  
Highly Active ◽  
Healthy Control

INTRODUCTION: HIV-infected children and adolescents treated with highly active antiretroviral therapy (HAART) regimens that include a protease inhibitor (PI) can show significant improvements in clinical outcomes, nutritional status and quality of life. The study aimed to report nutritional and metabolic alterations for pediatric patients continuously exposed to HAART and for healthy controls for up to 1 year. METHODS: Clinical, anthropometric, lipid profile and food intake data were collected prospectively over approximately 12-months for each patient. RESULTS: Fifty-one individuals were studied, of these, 16 were healthy. After 12 months follow-up, HIV-positive individuals remained below the healthy control group parameters. No change was observed concerning food intake. Triglyceride serum levels were higher in patients using protease inhibitor at the onset of the study [PI groups: 114 (43 - 336), and 136 (63 - 271) versus control group: 54.5 (20 - 162); p = 0.003], but after twelve months follow-up, only the group using protease inhibitor for up to two months presented higher values [140 (73 - 273) versus 67.5 (33 - 117); p = 0.004]. HDL-cholesterol was lower in HIV-positive individuals [HIV-positive groups: 36 (27 - 58) and 36 (23 - 43); control 49.5 (34 - 69); p = 0.004]. CONCLUSIONS: HIV-infected children and adolescents treated with highly active antiretroviral therapy showed compromised nutritional parameters compared to a paired healthy control group. Individuals using protease inhibitor presented worse triglyceride serum levels compared to their healthy counterparts.

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