Welcome to HIV Weekly, an email bulletin that will provide people with, or affected by, HIV with a concise, plain English digest of a selection of the very latest HIV news.
This new digest puts the latest HIV news stories into their context to equip you with the knowledge to understand what the latest research might mean for your HIV treatment and care.
Information on the latest NAM treatment information resources and those produced by other key organisations such as the UK Coalition and THT are also included.
HIV Weekly is edited by Michael Carter, NAM's patient information and news editor.
This week’s edition is a special and provides an overview of some of the key research presented to Seventh International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, which was held in Dublin last week.
What is lipodystrophy?
Lipodystrophy is a set of side-effects thought to be associated with HIV treatment. It can involve fat accumulation around the waist or back of the neck; fat loss from the face (often called facial wasting); loss of fat from the limbs and buttocks; or a combination of these.
Increases in blood fats can also be caused by anti-HIV treatment and this can increase the long-term risk of other health problems including heart disease, diabetes, and stroke.
Causes of lipodystrophy
There has been controversy about the exact causes of lipodystrophy. Although there is growing agreement that the condition is a side-effect of anti-HIV drugs (particularly AZT [zidovudine, Retrovir] and d4T [stavudine, Zerit]), some have argued that factors such a very low CD4 cell count before anti-HIV treatment, body type and race are equally important.
A study involving over 100 patients presented to the conference has shown that it is anti-HIV drugs that cause body shape changes to occur.
The study was intended to look at the ability of two different combinations - d4T and ddI (didanosine, Videx) with a non-nucloside reverse transcriptase inhibitor (NNRTI) or AZT and 3TC (lamivudine, Epivir ) with an NNRTI of anti-HIV drugs to control viral load.
Researchers found that people taking the d4T/ddI combination were three times more likely to experience fat loss. Experiencing a large increase in the blood fat called triglycerides after eight weeks of treatment also predicted who would experience fat loss.
Neither race nor CD4 cell count before starting treatment was associated with fat loss.
Another study looking at biopsies (skin samples) obtained from men with fat loss also showed that specific anti-HIV drugs were to blame. People who had taken AZT or d4T had lower levels of mitochondria in their fat cells. Mitochondria carries energy in cells and damage to mitochondria is the reason people experience fat loss.
One of the joint chairs of the conference, Prof. William Powderley of University College Dublin was in no doubt about the importance of the study. He said, “large numbers of people are being exposed to an avoidable toxicity. The presentations at this meeting show the overwhelming influence of drug choice on the development of lipoatrophy.”
Treating lipodystrophy
Living with lipodystrophy
NAM published a book called Living with HIV . It provides an introduction to the key issues involved in life with HIV in the UK today.
The book also contains first hand accounts from people with HIV about their experiences. Here is Edwin’s experience of facial fat loss and its treatment. If you would like to contribute your experiences of lipodystrophy or any other aspect of life with HIV email michael@nam.org.uk
New life, New Fill, by Edwin
Lipodystrophy resources from NAM
NAM publishes a wide range of information on lipodystrophy.
You may want to start by reading the introductory factsheet on lipodystrophy which is available here.
There is also a booklet that provides an overall summary of the issues involved in lipodystrophy. To read it click here.
Living with HIV has a detailed section on lipodystrophy and includes a first hand account of coping with facial wasting and its treatment (reproduced above).
For a comprehensive overview of lipodystrophy and an examination of key research into the subject click here.
Factsheets are also available on specific aspects of lipodystrophy, including facial wasting, high blood pressure, stroke, and the heart. There is also a factsheet on exercise, a subject which is also covered in the book Living with HIV.
Detailed information on heart disease and HIV treatment and research into this area is available here.
Lipodystrophy, cardiovascular health and exercise are regularly covered in NAM’s monthly newsletter ATU. The January/February 2006 edition has weight loss/gain and exercise as its theme and will be out in late December. To subscribe click here.
Every month NAM has an information forum in central London and normally one forum a year is on lipodystrophy when a senior doctor involved in lipodystrophy treatment and research will talk about latest developments. There is always the opportunity to ask questions. To keep up-to-date with future forums click here.