Important note: Information in this article was accurate in October 2000. The state of the art may have changed since the publication date.
Subjects who enrolled in the study detailed above were carefully screened by researchers. Those people who had the following complications or issues were not allowed into the study:
According to the researchers, the results from this study do not apply to the average person with HIV/AIDS who has lipodystrophy and who may have more severe liver damage.
In non-HIV-infected people there is a small risk of developing high levels of lactic acid (lactic acidosis) and resulting complications. Some PHAs using nukes appear to be at increased risk for the development of lactic acidosis. In this study, levels of lactic acid fell to a greater degree in people who did not receive metformin. It is possible that long-term use of metformin may increase the risk of lactic acidosis in PHAs who use nukes. This study lasted for only three months. It will be interesting to see what happens to lactic acid levels in PHAs who use metformin for longer periods.
In non-HIV-positive people, metformin can interefere with the absorption of vitamin B12. Some PHAs appear to be at increased risk for vitamin B12 deficiency compared to non-PHAs. Doctors may also wish to consider suggesting supplements of this vitamin (injected, intranasal or sublingual) as well as the mineral calcium, which can increase absorption of vitamin B12 in their patients who use metformin. In the next article we present research findings on the effect of calcium on vitamin B12 absorption in people using metformin.
1. Tang AM, Graham NM, Chandra RK and Saah A. Low serum vitamin B12 concentrations are associated with faster human immunodeficiency virus type 1 (HIV-1) disease progression. J Nutr 1997 Feb;127(2):345-51.
2. Remacha AF, Riera A, Cadafalch J, and Gimferrer E. Vitamin B-12 abnormalities in HIV-infected patients. Eur J Haematol 1991 Jul;47(1):60-4.
3. Hadigan C, Corcoran C, Basgoz N, et al. Metformin in the treatment of HIV lipodystrophy syndrome: a randomized controlled trial. JAMA 2000 Jul 26;284(4):472-7.
4. Gérard Y, Maulin L, Yazdanpanah Y, et al. Symptomatic hyperlactataemia: an emerging complication of antiretroviral therapy. AIDS 2000;14(17):2723-2730.
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