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In spite of recent investigations, it is not known whether and to what extent the main features of lipodystrophy \u2013 that is lipoatrophy of peripheral fat at face, limbs and buttocks, as well as fat accumulation at breasts, abdomen and the dorso-cervical region \u2013 can be reversible once clinically manifest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 35 year old Caucasian HIV infected female developed severe diffuse lipodystrophy while on highly active antiretroviral therapy. A remarkable increase of breast size, fat accumulation at waist, and a fat pad on her lumbar spine were paralleled by progressive and disfiguring lipoatrophy of face, limbs and buttocks. The patient decided to interrupt her therapy after 20 months, with a stably suppressed viremia and a CD4 lymphocyte count &gt;500\/\u03bcL. She could carry on a safe treatment interruption for longer than 4 years. Most sites of fat accumulation switched to nearly normal appearance, whereas lipoatrophy was substantially unchanged at all affected sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>our observation provides pictorial evidence that lipoatrophy may not be reversible even under ideal circumstances. Therefore, strategies to prevent lipoatrophy should be considered when defining therapeutic regimens for HIV infected patients, especially those at high risk.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2334-5-80","type":"journal-article","created":{"date-parts":[[2005,10,4]],"date-time":"2005-10-04T06:14:18Z","timestamp":1128406458000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Persistence of lipoatrophy after a four-year long interruption of antiretroviral therapy for HIV1 infection: case report"],"prefix":"10.1186","volume":"5","author":[{"given":"Giustino","family":"Parruti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe Marani","family":"Toro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2005,10,3]]},"reference":[{"key":"228_CR1","doi-asserted-by":"publisher","first-page":"F51","DOI":"10.1097\/00002030-199807000-00003","volume":"12","author":"A Carr","year":"1998","unstructured":"Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, Cooper DA: A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. 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