rom the moment HIV enters a person’s body, it attacks the immune system, weakening their defences against infection and disease. The virus affects their entire body and can be manifested in everything from aches and pains to kidney damage and seizures.

In about a quarter of those infected, HIV affects the manner in which fat is produced, used, and stored. As a result of this metabolic disorder, called lipodystrophy, some patients lose weight and assume the gaunt appearance most often associated with the virus.
Others gain fat in the abdomen — mostly around the liver, stomach, and other organs — the chest, and on the back of the neck between the shoulders.

Fat gain is problematic in the abdominal cavity because it increases the risk of diabetes and heart attack. Excess fat in the breasts can be painful and, when it’s on the back of the neck, it can lead to headaches and respiratory problems.

Many experts attribute lipodystrophy to both the virus and medications used to treat the virus.

Health care providers believe lifestyle is also a contributing factor, so they urge those infected with HIV to follow a healthy diet and exercise daily to help build muscle and reduce fat build-up.

These days, people infected with HIV can live long lives so they need to be mindful of their health, says Alex Klein, a Toronto-based primary care doctor. “Individuals with HIV can’t afford to live each day as though it’s their last.”

When diet and exercise aren’t enough, Dr.Klein often prescribes medication that contains a growth hormone-releasing factor and reduces excess abdominal fat. It’s not a cure for lipodystrophy — there is none — but it improves the lives of those who take it.

Dr. Klein hopes to see the day that all provincial health plans cover the cost of the medication, so more patients have access to it.

In the meantime, people infected with HIV need not despair. “HIV is no longer a death sentence, and there are now ways to manage it,” he says. “People who have the virus should never use it as an excuse to give up on themselves.”