Press room ... 2000 archive

Update from the 2nd International Workshop
on Adverse Drug Reactions & Lipodystrophy in HIV

September 27, 2000

San Francisco, CA—About four hundred researchers, activists and clinicians attended this workshop in Toronto, Canada from September 13–15, 2000. The following is a brief report from the Workshop. More information will be available in future Project Inform publications.

Mitochondria and Anti-HIV Therapy

Preliminary results from a small study shows that people on nucleoside analogue reverse transcriptase inhibitors (NARTIs) have fewer mitochondria in cells compared to HIV+ individuals not taking NARTIs or HIV negative individuals. Mitochondria can be likened to the energy source of cells. This reduction in mitochondria was only seen among people taking d4T (stavudine, Zerit) and not seen among people on any other NARTI. The average number of mitochondria in cells decreased by 44% among people on d4T and this translated to a 0.6% decrease in the number of mitochondria per month. One interesting observation from this study was that people with fat loss in the face, arms or legs (called lipoatrophy) had decreased number of mitochondria in cells whereas people who had developed an accumulation of fat at the base of the neck (sometimes called buffalo hump) had an increase in the number of mitochondria.

For more information on mitochondria, please call the Project Inform Hotline and ask for Mitochondrial Damage and Lactic Acidosis.

Another study also looked at the number of mitochondria in cells. Forty people participated in this study, ten with fat wasting (group A), ten without any signs of fat redistribution (lipodystrophy) (group B), ten people who had never taken anti-HIV therapies (group C) and ten HIV-negative people (group D). The number of mitochondria cells was looked at from tissue samples from the back of the neck, the abdomen area and the mid thigh. This study found that people in group A had fewer mitochondria in cells than those in group B who in turn had fewer mitochondria in cells than those in group C or D. There were no differences in the number of mitochondria found in cells between people in groups C or D.

Protease Inhibitors and Changes in Body Composition

New results suggest that the protease inhibitors may have different mechanisms in their role in changes in body composition that has been observed in some people with HIV (called lipodystrophy syndrome). A group in Seattle has previously reported that when ritonavir (Norvir) was given to HIV-negative individuals for two weeks, they experienced a significant rise in cholesterol and triglyceride levels. Now a group from San Francisco has given indinavir (Crixivan) to HIV-negative individuals for four weeks. There were no significant increases in cholesterol or triglycerides but people had a marked decrease in insulin sensitivity (a marker associated with diabetes), something that was not studied by the Seattle group. Changes in these laboratory markers associated with the way the body uses fats and sugars are believed to be part of the lipodystrophy syndrome.

One small study suggests that the use of human growth hormone may be of some benefit for people with fat accumulation. Seven people, four of whom had a buffalo hump and three with accumulation of fat in their mid-section, behind the muscle (called abdominal or central obesity) received 3mg/day of human growth hormone for six months. Five people completed the six months course of treatment, one person had to stop because of elevated glucose levels and another moved away from the study site. All five who completed the six months had a decrease in their fat accumulation with an average reduction of 4.4kg (about 10 pounds) in total fat and a 5.4kg increase in muscle mass (also called lean body mass).