In recent years,
lipodystrophy and its related complications have become one of the major problems confronting HIV-infected patients on antiretroviral
therapy. More than ten years after having been described for the first time, comprehensive knowledge of its underlying molecular basis, the natural history of body fat changes and metabolic abnormalities, and even a working definition of
lipodystrophy are all still lacking. No standardized objective assessment of body fat has been incorporated into clinical practice for patient monitoring. Although a huge amount of data has been generated, no clinically proven treatment for any feature of
lipodystrophy is currently available. The only intervention that has been shown to reverse lipoatrophy had been the discontinuation of
thymidine analogues, although even then the results obtained are at most partial or modest. Recently published studies using
uridine (NucleomaxX) and
pravastatin resulted in a significant increase of subcutaneous fat. The potential for reversing
lipodystrophy once it has developed is limited, but promising results in preventing it are obtained with
thymidine analogue-sparing initial antiretroviral regimens. These results raise the question of whether we may be facing a definitive
solution to the
lipodystrophy syndrome.