HIV-infected patients with lipodystrophy may have an impaired quality of life (QOL). Blanch et al identified factors that can help identify those patients who may benefit from interventions to increase their quality of life. The authors are from the University of Barcelona, Spain

Risk factors:

(1) female gender

(2) injection drug user

(3) moderate to severe side effects of antiretroviral therapies

(4) longer duration of HIV infection

(5) lipodystrophy changes affecting the legs, abdomen, breast or face, all of which are sites that are potentially visible



• Duration of HIV infection could be a marker for increased side effects, since these patients often have developed resistance to simple regimens.

• Lipodystrophy changes involve thinning in the face and extremities and fat deposition in the breasts and abdomen.


After multivariate analysis, the main determinants of impaired QOL were:

(1) lipodystrophic changes in the breast

(2) side effects of antiretroviral therapies


Basis for impaired quality of life:

(1) shame and poor self image, with a need to hide the deformity

(2) depression

(3) isolation with impaired intimacy

(4) feeling ill from severity of drug side effects

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