Adiponectin and HIV associated lipodystrophy.
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A large case-control study finds that lipoatrophy is the predominant fat abnormality in HIV-infected patients, and a small randomized, placebo-controlled study finds benefit for rosiglitazone for insulin resistance.
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Atazanavir is a once-a-day non-pepsidic inhibitor of HIV protease which is licensed for use in the UK and the USA. One of its major advantages is that it does not produce lipid abnormalities in patients who receive it. This feature has been widely interpreted as implying that in the future there will be no abnormalities associated with fat redistribution when the drug is administered. This article explores that view.
OBJECTIVES: The recent use of antiretroviral drugs in people with HIV infection produced a drastic reduction in mortality and a remarkable improvement in the quality of life for these patients. However the aesthetic and psychological consequences that come from the reorganization of the adipose tissue induced by these drugs (facial wasting, buffalo hump) may reduce this state of wellbeing. METHODS: Our group, in cooperation with the 3rd Division of Infective Diseases of the University of Rome "La Sapienza", decided to evaluate the efficacy of polylactic acid (PLA) in combating these problems in HIV positive patients undergoing treatment with antiretroviral drugs in an evaluating study of 4 cases. The evaluation of the obtained results was performed by follow-up at one, three, six and twelve months from the first infiltration and considering the clinical evaluation, the photographical documentation and the patient's judgement. RESULTS: In all cases we obtained an improvement of the local condition with the restoration of a more booming aspect. The change was noted both within the family and the work environment. In the first three cases the results were considered as optimal by both the operators and the patients. In the fourth case the result was evaluated as discreet (a remarkable loss of weight of the patient in the months following the treatment should be taken into consideration). CONCLUSIONS: We think a new study with ultrasonography of dermal thickness before, during and after the treatment is necesary. This study will give a more reliable evaluation of the product efficacy.
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