Cytokines, chemical messengers that regulate immune system function, may also be involved. In addition, it may be useful to take body measurements and photographs to help detect changes. Gabriel Torres has reported on five patients who had a reduction in the size of their buffalo humps after starting growth hormone. Anabolic steroids such as nandrolone may help reduce fat abnormalities, and are currently under study. Some researchers have noted that rates of body fat abnormalities appear to be higher in people with HIV who are not taking steroids.
Liposuction uses a high-power vacuum to remove subcutaneous fat.
Some people have had success using liposuction to remove buffalo humps, but the fat pads may later reappear. Liposuction cannot be used to reduce truncal obesity, since it can only remove fat near the surface, not deep within the abdominal cavity. Some doctors have tried interventions such as silicone implants to fill in the cheeks of people who have lost fat in the face. Although protease inhibitors and other potent anti-HIV drugs are under suspicion as a factor in body fat redistribution and metabolic abnormalities, more data are needed. With Donald Kotler, Andrew Carr, Gabriel Torres, Matthew Sharp, and Ronald Baker.