Lipodystrophy syndrome(s)

November 2001     View PDF     En español

Protease inhibitors and lipodystrophy

New results suggest that each protease inhibitor may contribute differently to body composition changes. A group in Seattle reported that when ritonavir (Norvir) was given to HIV-negative people for two weeks, they experienced a significant rise in cholesterol and triglyceride levels. Now a group in San Francisco has given indinavir (Crixivan) to HIV-negative individuals for four weeks. There were no significant increases in these levels, but people had a marked decrease in insulin sensitivity (a marker of diabetes), something not studied by the Seattle group. Changes in these markers (the way the body uses fats and sugars) are believed to be part of lipodystrophy syndrome.

Another small study suggests that using human growth hormone (rHGH) may benefit people with fat accumulation. Seven people, four with buffalo humps and three with central obesity, used 3mg/day of rHGH for six months. Five people completed the six months, one stopped due to elevated glucose levels and another moved away. All five who completed the course had decreased fat accumulation with an average reduction of 4.4kg (about 10 pounds) in total fat and 5.4kg increase in muscle mass (lean body mass). It is unclear, however, whether this fat loss corrected the lipodystrophy at specific sites or was the normal outcome from using rHGH, which favors the growth of muscle tissue in general.

These early results hinting on the cause of lipodystrophy need to be confirmed. A complicating factor is whether all drugs in the same class will have the same effect and therefore cause the same side effect. It may be necessary to do studies for each drug.