Zinn, Richard Joseph2014-09-102014-09-102014http://hdl.handle.net/10539/15467A research report submitted to the Faculty of Medicine, University of the Witwatersrand, in partial fulfillment of the requirements for the Degree of Master of Medicine in the division of Plastic and Reconstructive Surgery. Johannesburg 2014With 67% of the world’s human immunodeficiency virus (HIV) infected population existing in Sub-Saharan Africa and recent access to highly active antiretroviral therapy (HAART); demand for plastic surgical intervention in addressing HIV-associated lipodystrophy has expanded dramatically. This study assessed the prevalence of lipodystrophy in a random clinic cohort, the demand for surgical correction, and risk of treatment non-compliance A questionnaire and database cross-sectional review of 554 patients was performed over a three-month period at the Themba Lethu Clinic, Johannesburg, South Africa. A total of 479 patients completed the questionnaire, 83% were female. Nearly 90% of patients were currently being treated, or had been treated with stavudine (d4T). The prevalence of lipodystrophy was 11.7%. Nearly 5.9% of patients had considered stopping treatment due to changes in body morphology following the onset of HAART, 47% of patients interviewed would consider surgery to correct unwanted physical changes following treatment with HAART. Male patients were satisfied by physical changes in their body habitus following treatment (pre-treatment satisfaction 38% vs. post-treatment satisfaction of 94%). Female patients had 6.5 times more breast hypertrophy related symptoms than in their pretreatment state. This study identified a prevalence of 11.7% of patients with HIV-associated lipodystrophy. A total of 3.8% of all patients would consider non-compliance on the basis of this side effect alone. The demand for surgical correction is significant, extends beyond patients diagnosed with HIV-associated lipodystrophy, and needs to be addressed.enGynecomastiaAntiretroviral Therapy, Highly ActiveThesis