Important note: Information in this article was accurate in August 2000. The state of the art may have changed since the publication date.
The precise cause or causes of the body shape changes and abnormal lipid and hormone levels observed in HIV lipodystrophy syndrome are not clear. It may be that several syndromes are in play, such as one that causes people to gain fat, another to lose fat and still another that leads to elevated levels of sugar and insulin in the blood. Although some changes in body shape occur in small numbers of people not taking anti-HIV drugs, most reports about body shape changes are about people who do use such drugs.
The role that each different class of drugs - nucleoside analogues (nukes), non-nucleoside analogues (non-nukes) and protease inhibitors (PIs) - plays also needs to be clarified. It appears that body shape changes, particularly fat wasting, can occur in people using nukes alone. Protease inhibitors appear to speed up this process of fat wasting when used with nukes. Again, how and why this happens is unclear. In this issue of TreatmentUpdate we highlight data from selected abstracts and posters presented at the 2nd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, which was held in Toronto from September 13 to 15, 2000.
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