Important note: Information in this article was accurate in August 2000. The state of the art may have changed since the publication date.
Some doctors in San Francisco think that high levels of "bad" cholesterol (LDL or low density lipoprotein) are associated with the fat accumulation seen in HIV lipodystrophy syndrome. Having high levels of "good" cholesterol (HDL or high density lipoprotein) is not linked to fat accumulation in non-HIV-infected people. The researchers speculate that if they could raise HDL levels in PHAs, they might be able to decrease the amount of fat accumulated by people with lipodystrophy.
To test this idea, doctors recruited six HIV-positive subjects taking HAART who had experienced an increase in abdominal fat while on therapy. Subjects took the B-complex vitamin niacin orally in gradually increasing doses until they were able to tolerate 1,000 mg three times daily. Those subjects who were able to take this amount of niacin for more than three months had decreased abdominal fat (measured by CAT scans) as well as significantly increased levels of good cholesterol. Triglyceride levels fell during the study, but this decrease was not statistically significant. These promising findings need to be confirmed in a larger study.
1. Fessel WJ, Follansbee SE, Luu TT, et al. Fat expansions, in patients on HAART with fat redistribution syndrome, shrink after niacin-induced increase in plasma HDL. Poster P96.
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