There are currently an estimated 24,731 cases of Human Immunodeficiency Virus (HIV) in Australia. This virus attacks the immune system and as the disease progresses makes people susceptible to catching opportunistic infections. The virus can also enter the brain tissue giving rise to neurological complications such as cognitive deficits, sensory changes and weakness.
Physiotherapists and Occupational Therapists have the skills to treat many of the complications of HIV and AIDS due to our knowledge of the condition and of the neurological system.
So what is Lipodystrophy Syndrome?
The term ‘lipodystrophy’ can be broken down to reveal exactly what it means. ‘Lipo’ refers to fat and ‘dystrophy’ refers to abnormal growth or change. Put it together and what you’re left with is exactly what’s being seen in a number of people living with HIV: abnormal fat changes. The medical literature also refers to lipodystrophy as ‘fat redistribution syndrome’.
Lipodystrophies can be a possible side effect of antiretroviral drugsused to treat the body’s immune system in people with HIV. Scientists are unsure why and how this happens.
What is commonly seen is a build up of visceral fat around the gut deep within the body. A build up of fat is also seen on the back of the neck, breasts and shoulders
A loss of fat can occur in the legs, arms, buttocks and face giving the appearance of sunken cheeks.
Many HIV-positive people taking HIV medications also experience high levels of fats in the blood. The two types of lipids that increase are triglycerides and cholesterol. Increased cholesterol levels can increase the risk of a heart attack or stroke. Increased triglycerides can increase the risk of damage to the pancreas (pancreatitis).
High levels of sugar in the blood can occur in some people with HIV. This can lead to diabetes which requires medical management.
In summary, Lipodystrophy Syndrome can increase cardiac risk factors, especially as we get older.
So, what do we know can reduce cardiac risk factors?
Lifestyle changes can play a strong part in reducing cardiac risk factors. These changes include maintaining a healthy weight, stopping smoking, managing stress and exercise.
What type of exercise?
There have been many studies done looking at the right type of exercise for people with HIV including two large systematic reviews. A combination of progressive resistance and aerobic exercise is suggested three times a week.
HIV is complex and people with HIV should be assessed and prescribed a program by either a knowledgeable physiotherapist or exercise physiologist. This ensures that the program is individualised given the broad range of symptoms that people with HIV present with. In other words, everyone is different and your program should be tailor made!