11. Anthropometry and Lipodystrophy

11.1 Anthropometry

The circumferences should preferably be measured on standing subjects while they are semi-clothed, i.e. waist uncovered with the subjects wearing underclothes only. If this is not possible to follow, the alternative is to measure the circumference on subjects without heavy outer garments with all tight clothing, including the belt, loosened and with the pockets emptie.

Waist circumference
Record the measurement of the circumference at a level midway between the lower rib margin and iliac crest in cms to the nearest centimeter.

Hip circumference
Record measurement of maximum circumference over the buttocks in cms to the nearest centimeter.

11.2 Lipodystrophy

Fat-Wasting
Fat loss in any of the following regions: face, arms, legs, buttocks, breasts, neck. Presence of at least one patient-reported physical change confirmed on physical examination, irrespective of antiretroviral therapy or it's composition.

Fat-Accumulation
Fat accumulation in any of the following regions: face, arms, legs, buttocks, abdomen, breasts, neck (including «buffalo hump»). Presence of at least one patient-reported physical change confirmed on physical examination, irrespective of antiretroviral therapy or it's composition.