An increasing number of reports of body fat changes in people taking anti-HIV therapy have led to widespread fears that protease inhibitors may be causing unfortunate long-term side-effects.
Since the beginning of 1998 there have been a growing number of reports of changes such as:
- fat redistribution from the arms and legs to the stomach resulting in a pot belly
- growth of fat deposits at the back of the neck, the so-called `buffalo hump'.
- the onset of diabetes after starting protease inhibitor treatment
- big increases in levels of blood fats called cholesterol and triglycerides, sometimes to levels which pose a long-term risk of heart disease
- pancreatitis as a result of severely elevated triglycerides
All of these changes have been associated with use of protease inhibitors, but American endocrinologist (specialist in human hormones) Dr Don Kotler argues that what is now being seen is a consequence of the long-term physical stress of HIV infection. When people suffer prolonged stress, they also suffer sustained increases in levels of a hormone called cortisol. Kotler argues that the one factor which has been previously reported to cause all the body fat changes seen in people with HIV is elevated levels of cortisol. If cortisol levels can be controlled, long-term HIV therapy may remain relatively safe, he argues.
Read an account of his views on the causes of body fat changes at
http://www.thebody.com/tag/june98.html