Management of Bone Disease and Body Composition Changes

  • Author: Donald P. Kotler, MD (More Info)
  • Section Editor: Eric S. Daar, MD
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 5/7/18 (What's New)

Summary

    Insulin Sensitizers
    • Studies have shown decreases in waist circumference with metformin[Hadigan 2000] and increases in limb fat with pravastatin[Mallon 2006] in HIV-infected patients
    • Major emphasis for management of lipohypertrophy has revolved around the use of human growth hormone and the human growth hormone–releasing factor analogue tesamorelin
    Human Growth Hormone
    • Rationale for using human growth hormone is the known inverse relationship between visceral adipose tissue and secretion of human growth hormone[Veldhuis 1995]
      Human Growth Hormone–Releasing Factor
        Leptin and Other Interventions for Lipohypertrophy

        Action required

        Keywords: Fat Perturbations, Initial Antiretroviral Therapy, Switch Strategies, Treatment Complications

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