Protease inhibitor-associated angiolipomatosis

Treatment with protease inhibitors in some persons infected with HIV-1 is associated with a syndrome of lipodystrophy manifesting as peripheral lipoatrophy, relative central adiposity, insulin resistance, and serum lipid abnormalities. We report 3 cases of HIV-1 infected patients who experienced symptomatic angiolipomas shortly after starting antiretroviral therapy including the protease inhibitor indinavir. The mechanism behind this observation may be similar to that of previously reported protease inhibitor-associated fat redistribution, but instead involving the adipose tissue of discrete uncommon benign tumors.