Lipodystrophy syndrome(s)

November 2001     View PDF     En español

Symptoms and HIV drugs

At various times, lipodystrophy symptoms have been blamed on individual drugs, on classes of drugs, on therapy overall, or on HIV itself. Although the links between HIV drugs and the problem are not yet well defined, some important observations have been made.

One study compared people using protease inhibitors to those who were not. It showed that people on protease inhibitors were more likely to have much higher cholesterol levels.

66% of people using ritonavir (Norvir) and saquinavir (Invirase) had cholesterol levels high enough to require cholesterol-lowering treatment according to the standards by the U.S. National Cholesterol Intervention Program (NCEP) guidelines. However, only 32% of people taking indinavir (Crixivan) and 39% taking nelfinavir (Viracept) met the NCEP guidelines.

Another recent study showed that people who used ritonavir had a twenty times greater risk of high triglyceride levels than people treated with other protease inhibitors. Some participants used gemfibrozil (Lopid) and/or atorvastatin (Lipitor), the most active drugs used to lower cholesterol and triglyceride levels. They experienced only moderate success, suggesting that the problem is more complex than a simple increase in cholesterol or triglyceride levels.

These results suggest that protease inhibitors may also interfere with the drugs used to treat high cholesterol levels. Researchers have reported that a small number of people who stopped using protease inhibitors had significant improvements toward normal triglyceride and cholesterol levels. This may not always be the case, though, since some nucleoside analogue RT inhibitor drugs (NRTIs) and some non-nucleoside analogue RT inhibitors (NNRTIs) are also capable of increase cholesterol and triglyceride levels.