[10 years of lipodystrophy--and so many uncertainties]

HIV lipodystrophy is characterized by peripheral, subcutaneous lipoatrophy in the face, arms, legs, and buttocks and central fat accumulation in the neck, breasts, and abdomen (referred as lipohypertrophy). Lipodystrophy is associated with atherogenic lipid abnormalities, low levels of HDL cholesterol, insulin resistance, and, less commonly, hyperglycaemia. Causes of lipodystrophy are not completely elucidated. The prevalence of lipodystrophy ranges from 20% to 70% of the patients after one year of ART, depending on the type of ART, with lower prevalence in more recent studies of newer agents. Treatment strategies are disappointing. A multidisciplinary approach is now proposed in the Geneva University Hospital in order to coordinate efforts from different department, including internal medicine, infectiology or esthetic surgery for example.