What statement best describes HIV-associated lipodystrophy syndrome?

• A. Visceral adipose tissue loss with subcutaneous fat sparing
• B. Not observed in patients on HAART
• C. Lipodystrophy is not associated with insulin resistance
• D. It is characterized by subcutaneous fat loss with visceral sparing or accumulation

Answer: (D)

HIV-associated lipodystrophy syndrome shows redistribution of fat driven by HIV infection and antiretroviral therapy. The hallmark is loss of subcutaneous fat (lipoatrophy) in areas like the face, arms, and buttocks, often accompanied by central fat accumulation, including visceral adipose tissue and dorsocervical fat. Because patients can exhibit subcutaneous fat loss with either little change or clear increases in visceral fat, the best description is subcutaneous fat loss with visceral sparing or accumulation. This condition commonly pairs with insulin resistance and dyslipidemia, and it is indeed observed in patients on HAART rather than being absent.