Síndrome de lipodistrofia: nuevo desafío en el tratamiento de la infeción por VIH.

A B S T R A C T The use of highly active antiretroviral therapy for the treatment of the HIV infection has caused a significant impro- vement in the course of this disease. However, these therapies are associated to side effects which make difficult the manage- ment of these patients under long-term drug exposure. Among these, several metabolic abnormalities are frequent and may have important negative consequences. The lipodystrophy syndrome is a not well-defined entity which includes hyperlipi- demia, fat redistribution and insulin resistance. Its etiopathology is not clear, although the protease inhibitors are thought to play a major role. Besides the distress derived from the cosmetic changes, its impact on the development of cardiovascular di- sease is a worrisome issue. Several therapeutic strategies tried have improved parcially some of the metabolic abnormalities, but an effective and well-defined treatment is lacking. This syndrome represents a management issue that is yet to be optimally resolved.