I sank into a seat beside a young chap who was turned sideways and chatting with the fellow behind him, who was leaning forward.
Is there anything you'd like to tell everyone about yourself before we let the questions fly? Joel Gallant: I'm an assistant professor of medicine and epidemiology at the Johns Hopkins University School of Medicine, and associate director of the Johns Hopkins AIDS Service [in Baltimore, Md.].
I also run the Garey Lambert Research Center, which conducts clinical trials of new antiretroviral agents. Joel Gallant: I agree -- it IS confusing, which is why I try never to use the word "lipodystrophy." We used that term, along with "fat redistribution," back when we thought that fat was being "redistributed" from the face, arms, legs, and buttocks to other areas, such as the abdomen, breast, and the upper back ("buffalo hump"). So it's better to use more precise terms: "lipoatrophy" to describe loss of subcutaneous fat, and "fat accumulation" to describe ... It's also easy to confuse lipoatrophy with wasting, because they can look the same. That's what happened to people in the bad old days before we had effective therapy.
This chat is sponsored by Gilead Sciences, which produces several HIV medications. Our speaker for tonight's chat on lipoatrophy is Dr.
Joel Gallant, one of the United States' most knowledgeable HIV specialists. Gallant, we're honored to have you as our chat speaker tonight.
Original message from Michael H: Besides aesthetics, does lipoatrophy of the face pose any other health problems? Joel Gallant: No, there are no known health problems associated with facial lipoatrophy.
However, I have seen people with lipoatrophy of the legs or buttocks develop "compression neuropathies" (tingling or numbness) because their nerves are no longer padded by fat and can be compressed by sitting on a wallet, crossing your legs, etc. Joel Gallant: If you have no drug resistance and can take anything you want, then combinations that are unlikely to cause body shape changes would be either Truvada [generic name: tenofovir/FTC] or Epzicom [generic name: abacavir/3TC; also known by the brand name Kivexa] PLUS either Sustiva [generic name: efavirenz; also known by the brand name Stocrin], Viramune [generic name: nevirapine], or Reyataz [generic name: atazanavir] (preferably Reyataz boosted with Norvir [generic name: ritonavir]).I run a question and answer forum for people with HIV infection on the Johns Hopkins AIDS Service Web site ( With that, I think we're ready to start tackling everybody's questions. (Remember: Since this is a moderated chat, you won't see your question in the chat room until Dr. Wasting is loss of both fat and muscle, usually caused by uncontrolled HIV infection. Joel Gallant: You can't get lipoatrophy if you're not on medications. If you're losing weight after taking a drug holiday, maybe your body is trying to tell you something!And of course, I also take care of lots of patients! Gallant answers it.) Original message from Edward: Can you give us a definitive answer on the difference between lipodystrophy and lipoatrophy? It can also be caused by low testosterone levels, poor nutritional intake, malabsorption, or other endocrine problems. Moderator 1: Our live chat on lipoatrophy (fat loss) has begun!By the way, although this is supposed to be a chat about lipoatrophy, we can talk about fat accumulation, too. Please continue to submit any questions you may have for Dr.Moderator 1: Please keep in mind that there may be a delay of a minute or two between answers, as Dr. Joel Gallant, one of the United States' most knowledgeable HIV specialists. Gallant is the associate director of the Johns Hopkins AIDS Service, one of the foremost HIV medical centers in the United States; the editor of "The Hopkins HIV Report," a bimonthly HIV care newsletter; and the co-author of the seminal HIV treatment guide "Medical Management of HIV Infection." Original message from Brick: Fat loss may be due to insulin insensitivity, from what I can gather.But while Lane Bryant seems to be leading the charge when it comes to changing clothing options for curvier women, that doesn’t mean the retailer is doing everything right.