HIV Treatment Bulletin - Vol. 6, No. 1, December 2004 / January 2005
Simon Collins, HIV i-Base

This annual workshop, largely focused on lipodystrophy and metabolic complications, provides an opportunity to assess research developments over the previous year. It also addresses the implications on clinical practice, and to a more limited extent, the implications for clinical management. From a community perspective, this research is painfully slow, often based on in vitro cell studies and mouse and rat models.

The clinical approach for management of lipodystrophy in not addressed in a comprehensive way, but interesting individual studies, including treatment interventions, are usually included.

The meeting also includes invited lectures from expert in non-HIV related fields that gives useful insight into HIV-related lipids changes.

The areas covered in this report include:

• Nucleoside analogue-related mitochondrial toxicity and link to lipoatrophy: effect of non-thymidine analogues (abacavir and tenofovir)
• Nucleosides reduce PPAR-gamma: a role for rosiglitazone without thymidine analogues?
• Potential for uridine to treat mitochondrial toxicity: still only in vitro data
• 25% patients take Kaletra on an empty stomach: dietary advice often missed at ‘centre of excellence’
• rHGH reduces central fat accumulation in adolescent lipodystrophy
• Weight loss is associated with elevated PBMC proviral DNA levels
• Coronary artery bypass graft is safe in HIV-positive patients but shows higher risk of longer term events
• Endothelial dysfunction similar in ARV-experienced and -naïve patients
• Pravastatin improves lipid profiles but not endothelial function
• Indinavir impairs endothelial function without insulin resistance
• Treatment interruptions improve lipids within four weeks: IL-2 has no metabolic effect
• Improvement of lipids following switch to tenofovir
• HCV coinfection linked to discontinuing ART due to toxicity

Abstracts from this meeting are already online as part of the excellent AEGiS conference abstract library.

Unless stated otherwise, all references are to the Programme and Abstracts from the 6th IWADRLH meeting published in Antiviral Therapy 2004.

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