Recognizing excess visceral abdominal fat

Recognizing Excess Visceral Abdominal Fat

Central adiposity in HIV is marked by excess visceral abdominal fat

People with HIV (PWHIV) have an increased risk in developing excess visceral abdominal fat.1

Excess visceral abdominal fat is the abnormal accumulation of visceral fat in the abdominal cavity and is present around internal organs.2

Visceral abdominal fat:

155 cm2

Understanding central adiposity in HIV

The pathogenesis of excess visceral abdominal fat in PWHIV appears to be multifactorial, including contributions from:2

  • Antiretroviral therapy (ART)
  • HIV infection itself
  • Growth hormone (GH) deficiency3

Identify excess visceral abdominal fat with 3 simple steps2


Palpate the midsection for firmness or rigidity


Measure waist and hip circumferences


waist‑to‑hip ratio

Calculate your patients’ waist‑to‑hip ratio

Ensure both circumferences are entered with the same unit.

Waist circumference
Hip circumference

Indicators for excess visceral abdominal fat:2†‡


Waist circumference
≥37.4 in (95 cm)

Waist-to-hip ratio ≥0.94


Waist circumference
≥37 in (94 cm)

Waist-to-hip ratio ≥0.88

BMI and WC are independently associated with predicting excess visceral abdominal fat.4,5

BMI = body mass index; WC = waist circumference.
† Waist‑to‑hip ratio = waist circumference/hip circumference.
‡ Reference values are based on inclusion criteria in clinical trials.


  1. Moyle G, Moutschen M, Martínez E, et al. Epidemiology, assessment, and management of excess abdominal fat in persons with HIV infection. AIDS Rev. 2010;12(1):3-14.
  2. Lake JE, et al. Practical review of recognition and management of obesity and lipohypertrophy in human immunodeficiency virus infection. Clin Infect Dis. 2017;64(10):1422-1429.
  3. Rietschel, P, Hadigan C, Corcoran C, et al. Assessment of growth hormone dynamics in human immunodeficiency virus‑related lipodystrophy. J Clin Endocrinol Metabolism. 2001;86;504-10.
  4. Janssen I, Heymsfield SB, Allison DB, Kotler DP, Ross R. Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat. Am J Clin Nutr. 2002;75(4):683-688.
  5. Joy T, Keogh HM, Allison DB, Hadigan C, et al. Relationship of Body Composition to BMI in HIV‑Infected Patients with Metabolic Abnormalities. J Acquir Immune Defic Syndr. 2008;47(2):174-84.

IMPORTANT SAFETY INFORMATION (Please see below for full limitations of use and additional important safety information)


EGRIFTA SV® is indicated for the reduction of excess abdominal fat in HIV‑infected adult patients with lipodystrophy.

Limitations of Use:

  • The impact and safety of EGRIFTA SV® on cardiovascular health have not been studied.
  • EGRIFTA SV® is not indicated for weight loss management.
  • It is not known whether taking EGRIFTA SV® helps improve compliance with anti‑retroviral medications.


Do not use EGRIFTA SV® if patient:

  • Has a pituitary gland tumor, has had pituitary gland surgery, has other problems related to their pituitary gland, or has had radiation treatment to their head or a head injury.
  • Has active cancer.
  • Is allergic to tesamorelin or any of the ingredients in EGRIFTA SV®.
  • Is pregnant or planning to become pregnant.

Warnings and Precautions

Drug Interactions

Use in Specific Populations

Adverse Reactions

The most commonly reported adverse reactions include injection site reactions, arthralgia, pain in extremity, myalgia, and peripheral edema.

To report suspected adverse reactions, contact THERA patient support® at 1‑833‑23THERA (1‑833‑238-4372) or FDA at 1‑800‑FDA-1088 or

Please see full Prescribing Information for EGRIFTA SV®.