Clinical outcome after lipectomy in the management of patients with human immunodeficiency virus-associated dorsocervical fat accumulation

Abstract

Abstract Lipo-accumulation of the dorsocervical fat pad (“buffalo hump”) is a complication observed in people living with human immunodeficiency virus (HIV). We described the clinical outcome of people living with HIV with “buffalo hump” treated by excisional lipectomy. From April 2013 to March 2018, medical records of people living with HIV, who received care in our hospital have been evaluated. Among them, patients with dorsocervical fat accumulation treated by excisional lipectomy have been retrospectively assessed. Nine patients with “buffalo hump” among 2886 people living with HIV (3.1‰, 9/2886) were included. Eight were women with a mean age of 47.9\u200a±\u200a8.0 years old (range, 36–60). Most of them have been infected by blood transfusion (77%, 7/9) and the mean duration of HIV infection was 14.1\u200a±\u200a5.5 years (range, 6–22). The mean duration for antiretroviral therapy was 8.8\u200a±\u200a2.1 years (range, 6–11). The mean pre-ART CD4+ T cell count was 91.3\u200a±\u200a76.5\u200acells/μL (range, 4–233) and 477.4\u200a±\u200a271.8\u200acells/μL (range, 114–926) at the time of surgery. All 9 patients underwent excisional lipectomy of their hypertrophied dorsocervical fat pad. The mean size of the excised specimens was 14\u200a×\u200a11\u200a×\u200a6\u200acm. The median follow-up time was 24 months (range, 2–60), all 9 patients reported satisfaction with their results, with no recurrence has been observed. Corrective surgery used to treat localized fat accumulations in people living with HIV with “buffalo hump” showed a favorable effect and can therefore be considered when necessary. Whereas drugs such as integrase inhibitors may avoid lipo-accumulation related syndrome and should be given to people living with HIV in China.