Can atazanavir reverse body fat changes?

Switching to the protease inhibitor atazanavir (Reyataz) can result in rapid improvement in lipodystrophy-associated body shape abnormalities and blood lipids, according to a short series of case reports published in the April edition of AIDS. Atazanavir was recently licensed in the UK.

Three individuals, who received their HIV care in Germany, had received previous anti-HIV therapy including a protease inhibitor and were provided with access to atazanavir through an early access scheme due to elevated cholesterol and triglycerides.

In addition, all three patients had body fat changes. Fat accumulation in the dorsocervical region (buffalo hump) was present in all three individuals and one patient also had fat loss from the extremities and fat accumulation around the abdomen.

Within twelve weeks the two patients who only had buffalo hump experienced a decrease in these fat deposits indicated by a reduction in their collar size and the appearance of a dent over the dorsocervical region. The other patient’s waist size reduced. Body weight remained stable in all three individuals and none of the patients significantly changed their diet or started new exercise regimens.

In all three patients, blood lipids also fell significantly. However, there was a non-clinically significant increase in total bilirubin levels.

The atazanavir-containing regimens had a potent anti-HIV effect, with all three patients maintaining a good CD4 cell count and a viral load below 50 copies/ml.

"We propose that in patients with lipodystrophy syndrome, switching to atazanavir from established [protease inhibitors] could lead to a reversal of the metabolic alterations and most rapidly to a rapid regression of pre-existing body fat accumulations," conclude the investigators.

Further information on this website

Atazanavir - overview

Atazanavir, once daily protease inhibitor, now available in UK - news story