scholarly journals Excisional lipectomy versus liposuction in HIV-associated lipodystrophy

2021 ◽  
Vol 48 (6) ◽  
pp. 685-690
Author(s):  
Natalie Barton ◽  
Ryan Moore ◽  
Karthik Prasad ◽  
Gregory Evans
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Primary Treatment ◽  
Highly Active ◽  
Number Of Patients ◽  
Immunodeficiency Virus ◽  
Fat Redistribution ◽  
Successful Removal ◽  
Male Patients ◽  
Haart Therapy

Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies have described the successful removal of focal areas of lipohypertrophy with successful outcomes. This manuscript reviews the outcomes of excisional lipectomy versus liposuction for HIV-associated cervicodorsal lipodystrophy.Methods We performed a 15-year retrospective review of HIV-positive patients with lipodystrophy. Patients were identified by query of secure operative logs. Data collected included demographics, medications, comorbidities, duration of HIV, surgical intervention type, pertinent laboratory values, and the amount of tissue removed.Results Nine male patients with HIV-associated lipodystrophy underwent a total of 17 procedures. Of the patients who underwent liposuction initially (n=5), 60% (n=3) experienced a recurrence. There were a total of three cases of primary liposuction followed by excisional lipectomy. One hundred percent of these cases were noted to have a recurrence postoperatively, and there was one case of seroma formation. Of the subjects who underwent excisional lipectomy (n=4), there were no documented recurrences; however, one patient’s postoperative course was complicated by seroma formation.Conclusions HIV-associated lipodystrophy is a disfiguring complication of HAART therapy with significant morbidity. Given the limitations of liposuction alone as the primary intervention, excisional lipectomy is recommended as the primary treatment. Liposuction may be used for better contouring and for subsequent procedures. While there is a slightly higher risk for complications, adjunctive techniques such as quilting sutures and placement of drains may be used in conjunction with excisional lipectomy.

scholarly journals Ko-infeksi Human Immunodeficiency Virus (HIV) dengan Mycobacterium leprae

2017 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Yuni Eka Anggraini
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Hiv Positive ◽  
Case Control Studies ◽  
Highly Active ◽  
Number Of Patients ◽  
Immunodeficiency Virus ◽  
Leprosy Patients ◽  
Low Incidence ◽  
Hiv Negative

Human immunodefficiency virus (HIV) epidemic covers several countries with endemic leprosy without any significantincrease in the number of patients co-infected with HIV and leprosy, so it can be concluded that HIV-positive does notincrease the risk of developing leprosy. Clinicopathological spectrum of leprosy patients who are co-infected withHIV is not changed. Leprosy may be attributed to the presence of immune recovery syndrome after the administrationof highly active antiretroviral therapy (HAART). Long-term incubation period and the low incidence of leprosy inpatients with HIV make prospective cohort or case-control studies on the prevalence of leprosy among a group of HIVpositive and HIV negative hardly possible to be performed. The benefit of this circumstance is the HIV pandemicdoes not become a nuisance of the effort to control leprosy. Further studies on the molecular pathogenesis of M.leprae and other mycobacterial can provide an understanding of the differences of the pathogenesis in patients withHIV infection.

scholarly journals Long-Term Treatment with Lopinavir-Ritonavir Induces a Reduction in Peripheral Adipose Depots in Mice

2006 ◽  
Vol 50 (12) ◽  
pp. 3998-4004 ◽  
Author(s):  
Matthieu Prot ◽  
Laurence Heripret ◽  
Nathalie Cardot-Leccia ◽  
Christophe Perrin ◽  
Myriam Aouadi ◽  
...  
Keyword(s):  
Gene Expression ◽  
Highly Active Antiretroviral Therapy ◽  
Fold Increase ◽  
Term Treatment ◽  
Long Period ◽  
Highly Active ◽  
Long Term Treatment ◽  
Immunodeficiency Virus ◽  
Lipodystrophic Syndrome

ABSTRACT Highly active antiretroviral therapy (HAART) of human immunodeficiency virus-infected patients is associated with adverse effects, such as lipodystrophy and hyperlipidemia. The lipodystrophic syndrome is characterized by a peripheral lipoatrophy and/or fat accumulation in the abdomen and neck. In order to get insights into the physiopathological mechanisms underlying this syndrome, we treated mice with protease inhibitors (PIs) over a long period of time. Although atazanavir-treated mice presented the same circulating triglyceride concentration as control mice, lopinavir-ritonavir-treated mice rapidly became hypertriglyceridemic, with triglyceride levels of 200 mg/dl, whereas control and atazanavir-treated animals had triglyceride levels of 80 mg/dl. These results obtained with mice reproduce the metabolic disorder observed in humans. White adipose tissue (WAT) was analyzed after 8 weeks of treatment. Compared to the control or atazanavir treatment, lopinavir-ritonavir treatment induced a significant 25% weight reduction in the peripheral inguinal WAT depot. By contrast, the profound epididymal WAT depot was not affected. This effect was associated with a 5.5-fold increase in SREBP-1c gene expression only in the inguinal depot. Our results demonstrate that the long-term treatment of mice with PIs constitutes an interesting experimental model with which some aspects of the lipoatrophy induced by HAART in humans may be studied.

scholarly journals Liver function in children with human immunodeficiency virus infection before and after 6 months of highly active antiretroviral therapy

2018 ◽  
Vol 58 (4) ◽  
pp. 159-64
Author(s):  
Eva Jacomina Jemima Sapulete ◽  
I Gusti Ngurah Sanjaya Putra ◽  
Ketut Dewi Kumara Wati ◽  
Hendra Santoso ◽  
I Putu Gede Karyana ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Liver Function ◽  
Highly Active Antiretroviral Therapy ◽  
Aspartate Aminotransferase ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Fluconazole Therapy

Background Highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and improved survival rate in human immunodeficiency virus (HIV)-infected patients. Although the risk of morbidity has decreased, it has been replaced by other long-term complications, such as hepatotoxicity. Hepatotoxicity is often reflected in biochemical abnormalities of liver function, such as elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and aspartate aminotransferase-to-platelet ratio index (APRI). Objective To compare liver function spectrum (AST, ALT, and APRI) in HIV-infected children before and after at least 6 months of HAART. Methods This observational study (before and after) was conducted in pediatric patients with HIV infection who received HAART for at least 6 months at Sanglah Hospital, Denpasar. Data were collected from medical records. Results Forty-nine patients were observed in this study. The mean AST, ALT, and APRI levels before HAART were higher than after at least 6 months of HAART. Anti-tuberculosis treatment and fluconazole therapy were not confounding factors for AST, ALT, and APRI. Conclusion Liver function spectrum enzyme levels of AST, ALT, and APRI are improved after at least 6 months of HAART.

Anti‐HIV Therapy: Pipeline Approaches and Future Directions

2011 ◽  
Vol 1 (1) ◽  
pp. 1-8
Author(s):  
L.K. Dwivedi ◽  
Mansi Shrivastava
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Vaccine Development ◽  
Experimental Models ◽  
Hiv Vaccine ◽  
Future Prospects ◽  
Future Directions ◽  
Hiv Therapy ◽  
Highly Active ◽  
Immunodeficiency Virus

Human Immunodeficiency Virus (HIV), with about 30 million deaths and double infections in developing countries, is an open challenge today for global scientists. Developing safe and effective measurements against it has become the prime need of hour. Though, putting it at health priority, various efforts like chemotherapy, immune activation through vaccine development and others are made globally over the last decade. Consequently, Highly Active Antiretroviral Therapy (HAART) was introduced but fails to completely block the viral replication due to drug resistance and various other severe side effects. Moreover, the antigenic variability and lack of appropriate experimental models has backed it to be a great puzzle. However, to overcome the present hurdles and to emerge a preventive HIV vaccine, efforts at various platforms are continued. A renewed, coordinated research, preclinical studies, clinical trials together with sufficient long term scientific and commercial commitments are made. Few of the therapeutic efforts viz. RNA interference (RNAi) and nanotechnology based approaches to control the HIV, viral enzymes’ inhibitors and various preclinically trialed vaccines are reviewed in this paper. Also, the observed toxicity of existing therapeutic regimen, key challenges and future prospects for the development of better tolerated prophylactic HIV‐1 vaccine are discussed.

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