lipohypertrophy

[wtfimpoz]

I have an unusually fat neck and have always battled a "belly".  Even at my thinnest I've been this way.  LipoATROPHY gets a lot of attention, but does anybody know anything about its twin, lipoHYPERTROPHY, and which, if any, modern drugs are likely to cause it?  

EDIT:  I'm obviously not under the impression that I'm already experiencing body side effects from the drugs.  I am concerned that my body type predisposes me to this though.

[aztecan]

Howdy,

Yes, I have lipohypertrophy. Mine showed up after about a decade on Crixivan and AZT.

While you may have a predisposition for fat neck or a bit of a belly, as you mentioned, that doesn't necessarily mean you would be more likely to develop lipohypertrophy.

I was always quite thin, skinny, in fact.

The adipose tissue (fat) that is deposited with lipohypertrophy is visceral, meaning around the internal organs, not subcutaneous, or below the skin but above muscle tissue. The latter is what what most people call a "beer belly."

With lipo, you can do all the crunches and diets you wish, but it won't help.

Likewise, the hump is also made up of the same type of adipose tissue, which is more fiberous than regular fat.

That is why it is sometimes not possible to use liposuction to remove it, and it must often be surgically removed. The problem is, the removal may only be temporary, as it often returns.

Both lipoatrophy and lipohypertrophy may be a result of mitochondrial damage done by long-term use of some of the ARVs.

The most noted culprits for this were the old nukes, such as Zerit and, possibly, AZT, and some of the PIs, especially Crixivan, which I took for quite a while.

The newer meds are much less likely to cause this, they say. The newer PIs, such as Reyataz, are not supposed to promote this type of development. Likewise the newer nukes, like Truvada (Emtriva and Viread), are also supposed to be less likely to cause this.

I personally wonder whether there may be some connection between mitochondrial toxicity and hyperlipidimia, which can also be induced by the PIs.

There are no clear cut answers regarding what to watch out for or what meds to avoid. My hump developed quite quickly, in less than a year.

Were I going to start meds today, I would probably opt for one of the newer meds, such as Atripla, if I could tolerate it. It is unlikely you would start on any of the old first-line drugs like Crixivan unless there were some underlying need.

I hope this helps.

HUGS,

Mark