Impact of Lipodystrophy on the Quality of Life of HIV-1–Infected Patients

Abstract

The impact of HIV-related LD on QoL depends on certain patient characteristics, rather than on the presence of LD itself.

Severity of Lipodystrophy Is Associated with Decreased Health-Related Quality of Life

“…4,5 LD may result in an involuntary disclosure of HIV status and also appears to be correlated to suboptimal adherence to therapy. 6,7 Few studies have addressed quality-of-life issues in HIVinfected patients with LD, and its impact has not been es-tablished definitively. Some studies demonstrating effects have used instruments not widely validated in people with HIV infection, 8,9 while others have failed to find correlations with health-related quality of life.…”

Lipodystrophy syndrome associated with antiretroviral therapy in HIV patients: considerations for psychosocial aspects

“…of Spanish patients (9) . Investigations that analyzed the onset of lipodystrophy according to the symptoms, observed an increase in abdominal girth in 32 to 60% of individuals, breast enlargement in 20%, facial lipoatrophy in 58%, loss of peripheral fat in 33 to 50%, and mixed manifestations in 8 to 86 % of patients (9,(14)(15) .…”

“…Investigations that analyzed the onset of lipodystrophy according to the symptoms, observed an increase in abdominal girth in 32 to 60% of individuals, breast enlargement in 20%, facial lipoatrophy in 58%, loss of peripheral fat in 33 to 50%, and mixed manifestations in 8 to 86 % of patients (9,(14)(15) . According to the literature surveyed, the pathogeny of lipodystrophy continues to be largely unknown, although several risk factors for its occurrence have been described, including long-term HIV infection, prolonged use of protease inhibitors (14) and a CD4 count below 200 cells/mL (11) .…”

“…Therefore, patients with facial changes are more worried about stigmatization. Facial lipoatrophy was cited as an important stigmatizing factor for HIV patients, rendering them more vulnerable to the identification of seropositivity and consequently leading to decreased self-esteem and socialization (9)(10) .…”

“…In addition, BLANCH and colleagues (9) found that decreased sexual enjoyment and activity were observed after the development of lipodystrophy; however, there were no change in the frequency of condom use. Patients also felt less physically well and were less confident in their relationships during their experience of lipodystrophy (9) . Regarding compliance to antiretroviral therapy, one study found that some patients intended to interrupt or abandon treatment as a result of body changes (15) .…”