HIV-positive people are well known to develop unusual increases of fat in very specific areas of their bodies. The abdomen and neck are the two most common areas of this unique form of lipohypertrophy. While some plastic surgery fat reduction procedures can be done in the neck, the intraperitoneal location of the abdominal fat makes it impossible to treat with surgery.
In 2010 an injectable medication Egrifta (tesamorelin, Theratechnologies) was approved for specific use in HIV-positive patients with lipohypertrophy. Egrifta is a growth hormone-releasing factor medication that has been studied for the reduction of visceral (intraperitoneal) fat accumulations. This could be helpful for many patients who are on antiretroviral medications in which it is estimated that up to 1/3 of them will develop abdominal fat accumulation. Studies show that HIV-positive patients taking Egrifta had a near 20% reduction in visceral fat. While 20% may not sound that impressive, it translates into a very visible and satisfying external change in appearance. The visceral fat loss was maintained as long as Egrifta was taken but tended to show a reversal of the improvement when taken off the medication.
Egrifta is an injectable drug taken in a single subcutaneous injection per day that is self-administered. The injection is given into the abdominal area just like an insulin shot. It works by being an insulin-like growth factor (IGF-1) which does not interact or reduce the effectiveness of concurrently taken antiretroviral medications. While it was specifically studied for abdominal fat reduction, it is not known if it would be effective for the classic buffalo neck lipohypertrophy which is also known to develop from antiretroviral medication therapies.
Dr. Barry Eppley
Indianapolis, Indiana