Buffalo Hump and HIV-1 Infection: Current Concepts and Treatment of a Patient with the Use of Suction-Assisted Lipectomy

Abstract

Human immunodeficiency virus (HIV) - 1 infection, or its treatment with protease inhibitors, may be associated with abnormal fat deposition. One or more of several areas may be affected, including the dorsal-cervical fat pad (‘buffalo hump’), abdominal region (‘protease paunch’, ‘crixbelly’), breasts or as a generalized lipomatosis. Fat accumulation is most common in the dorsal cervical and the abdominal areas. Only a relatively small number of patients have been studied, therefore, the true incidence of this accumulation is not known. The present study describes an HIV-1-infected man who developed a very large buffalo hump after treatment with indinavir who was successfully treated using tumescent suction-assisted lipectomy. This is the first published report of a buffalo hump treated using this modality.