Table Of ContentLIPODYSTROPHY SYNDROME
INHIV
LIPODYSTROPHY SYNDROME
INHIV
edited by
Christine A. Wanke
and
Sherwood L. Gorbach
Tufis University Schoo/ ofM edicine
Springer Science+Business Media, LLC
Library of Congress Cataloging-in-Publication Data
A C.I.P. Catalogue record for this book is available
from the Library of Congress.
Lipodystrophy Syndrome in HIV edited by Christine A. Wanke and Sherwood L. Gorbach
ISBN 978-1-4613-5093-4 ISBN 978-1-4615-0471-9 (eBook)
DOI 10.1007/978-1-4615-0471-9
Copyright © 2003 Springer Science+Business Media New York
Origina1ly published by Kluwer Academic Publishers in 2003
Softcover reprint of the hardcover 1 st edition 2003
Ali rights reserved. No part ofthis work may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, electronic, mechanical,
photocopying, microfilming, recording, or otherwise, without the written permission
from the Publisher, with the exception of any material supplied specifically for the
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the purchaser of the work.
Printed on acid-free paper.
Table of Contents
Chapter Page
I Introduction
Chirstine A. Wanke and SherwoodL. Gorbach
II EpidemiologyofFat Redistribution inHIV 5
Abby H.Shevitz
III Body Composition in HIV Lipodystrophy 21
Hootan Khatami and Kathleen Mulligan
IV Methods for Assessing Body Composition in HIV-Associated
Lipodystrophy 39
DonaldP. Kotlerand Ellen S. Engelson
V Abnormalities in Glucose and Insulin in HIV Disease 65
Gary Meiningerand Steven Grinspoon
VI Abnormalities inLipidMetabolismin HIV 87
StefaniaLamon-Fava and ErnstJ.Schaefer
VII Pathogenesis ofHIV Lipodystrophy 107
CeciliaM. Shikuma, ScottSouza,and BruceShiramizu
VIII Nutrition and Metabolismin HIV-I-InfectedChildrenReceiving
HAARTTherapy 139
TracieL. Miller
IX Treatment of Hyperlipidemiaand Insulin Resistance with Diet 169
Margo N.Woods and Kristy Hendricks
x Potential Therapies fortheHIV-AssociatedLipodystrophy 213
Syndrome
ChristineA. Wanke
Index 229
vi
Contributors
Ellen S.Engelson
ColumbiaUniversity School ofMedicine, Gastrointestinal Division,
St. Luke's-RooseveltHospital Center, 1111AmsterdamAvenue,
New York, NY
SherwoodL. Gorbach
Tufts University School ofMedicine, Departments ofMedicine and
Community Health, 150Harrison Avenue, Boston, MA
Steven Grinspoon
NeuroendocrineUnit, Massachusetts General Hospital,Fruit Street,
Boston,MA
Kristy M.Hendricks
Tufts University School ofMedicine, Departments of Medicine and
Community Health, 150Harrison Avenue,Boston, MA
Hootan Khatami
University Of California, San Francisco,Departmentof Medicine,
San Francisco General Hospital, San Francisco,CA
Donald P.Kotler
ColumbiaUniversity School of Medicine,Gastrointestinal Division,
St. Luke's-RooseveltHospital Center, 1111AmsterdamAvenue,
NewYork,NY
StefaniaLamon-Fava
Jean Mayer USDA Human Nutrition Research Centeron Aging,
Tufts University School ofMedicine, Lipid and Heart Disease
Prevention Program, 750 Washington Street,Boston, MA
Gary Meininger
Neuroendocrine Unit, Massachusetts General Hospital, Fruit Street,
Boston,MA
Tracie L. Miller
University of RochesterSchool ofMedicine and Dentistry, Division
ofPediatric Gastroenterology and Nutrition, Rochester,NY
Contributors (Continued)
Kathleen Mulligan
University OfCalifornia, San Francisco, Departmentof Medicine,
San Francisco General Hospital, San Francisco, CA
ErnstJ. Schaefer
Jean Mayer USDA Human Nutrition Research Centeron Aging,
Tufts University School of Medicine,Lipid and Heart Disease
Prevention Program, 750 Washington Street, Boston, MA
Abby H.Shevitz
Tufts University School ofMedicine, DepartmentofCommunity
Health, 150Harrison Avenue,Boston, MA
CeciliaM.Shikuma
University ofHawaiiMedical School, DepartmentofMedicine,
Honolulu, Hawaii
BruceShiramizu
University ofHawaii Medical School, Departmentof Medicine,
Honolulu,Hawaii
ScottSouza
University of Hawaii Medical School,Department ofMedicine,
Honolulu, Hawaii
ChristineA. Wanke
Tufts University School of Medicine,Departments of Medicine and
Community Health, 150Harrison Avenue, Boston, MA
Margo N. Woods
Tufts University School ofMedicine, Departments ofMedicine and
Community Health, 150 Harrison Avenue, Boston, MA
V111
Acknowledgements
We would like to thank our colleagues and collaborators for their thoughtful
discussion and comments; our students and fellows for challenging us to
clarify our thinking. We are grateful to our patients and clinical study
participants for their gracious assistance in making clinical research possible.
Without the assistance of our support staff, volumes like this would not be
possible. Finally, but most importantly, we thank our families for their
ongoing support and encouragement.
Preface
The evolution ofdata about the HIV-Associated Lipodystrophy Syndrome has
been rapid.The syndrome itselfis complex and controversial. Although great
progress has been made in understanding epidemiology and etiology of the
syndrome, much about thesyndrome remains mysterious. It was our intention
to assist HIV providers with a framework for understanding the status and
complexities ofthe field.
Each author was requested to provide an evidence-based discussion ofa topic
for which they have expertise. While it is impossible that such a volume be
completely comprehensive, we believe that the approach of this book will
allow the reader to develop a relatively complete snapshot ofthe syndrome.
We also believe that the reader of this volume will be able to confront the
emerging literature on the HIV-associated lipodystrophy syndrome with a
critical eye and that the volume will provide a context in which to place
additional data as theyarepublished.
Christine A.Wanke
Sherwood L. Gorbach
CHAPTER I
INTRODUCTION
Christine Wanke, MD
Sherwood Gorbach,MD
Tufts UniversitySchoolofMedicine
Departments ofMedicineand CommunityHealth
Boston, Massachusetts
